RCMS AR Specialist I

Qualifacts; Vadodara; On-site; INR 240,000 - 360,000; Full time

Job summary

Qualifacts in Vadodara, India is seeking an AR/Denial Management Associate to investigate and resolve complex denial issues and analyze denial trends for process improvements. You will lead payer calls for escalated inquiries, develop strategies to reduce denial rates, and collaborate with internal teams to address root causes, while maintaining thorough documentation.

The role requires 0–1 year in AR/denial management, strong analytical skills, Excel proficiency, and excellent communication.

Qualifications

• Associate degree in Healthcare Administration, Business Administration, or related field (preferred).
• 0–1 year 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 Excel.
• Excellent verbal and written communication skills.
• Ability to manage multiple tasks and meet deadlines.
• Attention to detail and accuracy.
• Ability to work collaboratively in a team.
• Willingness to learn and adapt in a fast-paced healthcare revenue cycle setting.

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.

Skills

Analytical skills

Problem-solving

Excel

Communication skills

Teamwork

Education

Associate degree in Healthcare Admin

Tools

Microsoft Excel

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.

Job Description

• 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.