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.