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.
