About this role
Job Description:
Responsibilities:
- Investigate and resolve complex AR and denial-related issues.
- Analyze denial trends and identify process improvement opportunities.
- Initiate and lead payer calls for escalated denial inquiries and disputes.
- Develop strategies to reduce Aging and Denial rates and improve reimbursements.
- Collaborate with internal teams to address the root causes of denials.
- Mentor and support Level 1 associates on advanced AR and Denial management.
- Prepare, review, and submit appeals for denied claims.
- Maintain accurate documentation of denial activities, resolutions, and outcomes.
Requirements:
- Associate degree in Healthcare Administration or a related field (preferred).
- 2+ years of experience in Denial Management or Revenue Cycle Management.
- Proficiency in medical billing software and denial tracking systems.
- Strong analytical, problem-solving, and decision-making skills.
- Effective communication and negotiation skills with payers.
- Demonstrated leadership abilities and capability to work independently.
Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.