AR Specialist II

Tishman Speyer Properties; Vadodara; On-site; INR 300,000 - 540,000; Full time

Job summary

Qualifacts is seeking an experienced AR/Denial Management professional to investigate and resolve complex denial issues, analyze denial trends, and lead payer calls for escalations. The role focuses on reducing aging and denial rates while improving reimbursement through process improvements and collaboration with stakeholders.

Minimum 2 years in denial management or revenue cycle, with strong analytical and communication skills.

Qualifications

• Associate degree in healthcare administration or related field preferred.
• Minimum of 2 years of 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.
• Leadership skills and ability to work independently.

Responsibilities

• Investigate and resolve complex AR/Denial issues.
• Analyze denial trends to identify process improvements.
• Lead payer calls for escalated denial inquiries and disputes.
• Develop strategies to reduce aging and denial rates and improve reimbursement.
• Collaborate with internal stakeholders to address root causes of denials.
• Mentor Level 1 associates on advanced AR/Denial management techniques.
• Prepare and submit appeals for denied claims as needed.
• Maintain comprehensive documentation of denial activities and outcomes.

Skills

Denial management

Payer negotiation

Analytical skills

Communication with payers

Leadership

Education

Associate degree in healthcare administration

Tools

Medical billing software

Denial tracking systems

Job description

Job Description

• Responsibilities: 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 & Denial rates and improve reimbursement.
• Collaborate with internal stakeholders to address root causes of denials.
• Mentor Level 1 associates on 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).
• Minimum of 2 years of 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 effectively communicate with payers to negotiate claim resolutions.
• Leadership skills and ability to work independently.

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. For more than 20 years, Qualifacts has delivered thoughtful innovation, technology, support, and services to the behavioral health and human services market. Most recently, Qualifacts has been on a mission to expand its portfolio to support the patient continuum, from the initial appointment request to final billing and reporting, and everything in between. Qualifacts has headquarters in Nashville and Tampa with employees across the globe, many with strong healthcare and clinical backgrounds to help bring you the best solutions possible.