RCMS AR Specialist I

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).

· 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.