Responsibilities
Job Description:
- Investigate and resolve complex AR/denial issues.
- Analyze denial trends to identify areas for process improvement.
- Initiate and lead payer calls for escalated denial inquiries and disputes.
- Develop and implement strategies to reduce aging and denial rates while improving reimbursement.
- Collaborate with internal stakeholders to address root causes of denials.
- Mentor Level 1 associates in 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 a related field (preferred).
- Minimum of 1.5 years experience in denial management or revenue cycle management.
- Proficiency in medical billing software and denial-tracking systems.
- Strong problem-solving and analytical skills.
- Ability to communicate effectively with payers to negotiate claim resolutions.
Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
