RCMS AR Specialist II

Tishman Speyer Properties; Vadodara; On-site; INR 300,000 - 600,000; Full time

Job summary

Qualifacts is seeking an AR/Denial Management Analyst to join our team. A bachelor’s degree and strong problem solving and analytical skills are essential as you investigate complex denial issues and drive resolution.

You will analyze denial trends, initiate payer calls for escalated inquiries, and prepare appeals while maintaining thorough documentation. Candidates with 1–2 years in AR/denial management are encouraged to apply; Qualifacts values diversity and inclusion.

Qualifications

• Bachelor’s degree required.
• Strong problem solving and analytical skills.
• Candidates with 1–2 years of experience in Accounts Receivable (AR) & Denial Management.

Responsibilities

• Investigate and resolve complex denial issues.
• Analyze denial trends to 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 enhance reimbursement.
• Collaborate with internal stakeholders to address root causes of denials.
• Prepare and submit appeals for denied claims as needed.
• Maintain comprehensive documentation of denial activities and outcomes.
• Address denials at the root cause by requesting appropriate rules and system edits after partner approval.
• Identify and analyze denial trends and elevate to supervisor for further resolution.

Skills

Problem solving

Analytical skills

Education

Bachelor’s degree in any discipline

Job description

Job Description

Responsibilities

• Investigate and resolve complex denial issues.
• Analyze denial trends to 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 enhance reimbursement.
• Collaborate with internal stakeholders to address root causes of denials.
• Prepare and submit appeals for denied claims as needed.
• Maintain comprehensive documentation of denial activities and outcomes.
• Address denials at the root cause by requesting appropriate rules and system edits after partner approval.
• Identify and analyze denial trends and elevate to supervisor for further resolution.

Requirements

• Bachelor’s degree in any discipline.
• Strong problem solving and analytical skills and work towards resolution..
• Candidates with 1-2 years of experience in Accounts Receivable (AR) & Denial Management

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.