About this role
Job Description:
Responsibilities:
· Investigate and resolve complex denial issues.
· Analyze denial trends to identify areas for process improvement.
· Initiate and lead payer calls for escalated denial inquiries, follow-up and disputes.
· Develop and implement strategies to reduce denial rates and improve reimbursement.
· Collaborate with internal stakeholders to address root causes of denials.
· Mentor Level 1 is associate with advanced AR/Denial management techniques.
· Prepare and submit appeals for denied claims as needed.
· Maintain comprehensive documentation of denial activities and outcomes.
Requirements:
· Associate degree in healthcare administration or related field (preferred).
· Minimum of 2 years of experience in AR/Denial management or revenue cycle management.
· Proficiency in medical billing software and denial tracking systems.
· Strong problem-solving and analytical skills.
· Ability to effectively communicate with payers to negotiate claim resolutions.
· Leadership skills and ability to work independently.
· Attention to detail and accuracy in data analysis and reporting.
Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.