About this role
Job Description:
Responsibilities
• Investigate and resolve complex denial issues. • Analyze denial trends and identify opportunities for process improvement. • Initiate and lead payer calls for escalated denial inquiries, follow-ups, and disputes. • Develop and implement strategies to reduce denial rates and improve reimbursements. • Collaborate with internal stakeholders to address the root causes of denials. • Prepare and submit appeals for denied claims when necessary. • Maintain accurate and comprehensive documentation of denial activities and outcomes.
Requirements
• Associate degree in Healthcare Administration, Business Administration, or a related field (preferred). • 0 to 1 years of experience in AR/Denial Management or Revenue Cycle Management. • Basic understanding of medical billing, claims processing, and denial management concepts. • Strong analytical and problem-solving skills. • Proficiency in Microsoft Office applications, particularly Microsoft Excel. • Excellent verbal and written communication skills. • Ability to manage multiple tasks and meet deadlines. • Strong attention to detail and accuracy. • Ability to work collaboratively in a team-oriented environment. • Willingness to learn and adapt in a fast-paced healthcare revenue cycle setting.
Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.