AR Specialist II

Qualifacts; Vadodara; On-site; INR 600,000 - 800,000; Full time

Job summary

Qualifacts is seeking an experienced AR/Denial Specialist to investigate and resolve complex denial issues, analyze denial trends, and lead payer calls for escalations. You will develop strategies to reduce aging and denial rates and improve reimbursement, collaborating with internal stakeholders to address root causes.

The role requires an associate degree in healthcare administration and at least two years in denial management, proficiency with medical billing software, strong analytics, and

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 effectively communicate 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 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.

Skills

Medical billing software

Denial tracking systems

Problem solving

Analytical skills

Communication with payers

Leadership

Independent work

Education

Associate degree in healthcare administration

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.

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 & 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.