RCMS Denials Analyst II

Qualifacts Systems; Vadodara; On-site; INR 300,000 - 600,000; Full time

Job summary

Qualifacts Systems is seeking a detail-oriented professional to analyze and resolve complex denials in medical billing and claims processing. You will conduct thorough reviews to uncover root causes and implement corrective actions, collaborating with internal teams to ensure timely resolution.

The role also involves maintaining strong relationships with insurers and healthcare providers while staying informed on regulatory changes that impact denial rates.

Responsibilities

• Analyze and resolve complex denials related to medical billing and claims processing.
• Conduct thorough reviews of denied claims to identify root causes and implement corrective actions.
• Collaborate with internal teams to ensure accurate and timely resolution of denials.
• Develop and maintain relationships with external stakeholders, including insurance companies and healthcare providers.
• Stay up-to-date with industry regulations and changes in healthcare policies affecting claim denial rates.
• Identify trends and areas for improvement in the claims process and recommend changes to management.

Job description

• Analyze and resolve complex denials related to medical billing and claims processing.
• Conduct thorough reviews of denied claims to identify root causes and implement corrective actions.
• Collaborate with internal teams to ensure accurate and timely resolution of denials.
• Develop and maintain relationships with external stakeholders, including insurance companies and healthcare providers.
• Stay up-to-date with industry regulations and changes in healthcare policies affecting claim denial rates.
• Identify trends and areas for improvement in the claims process and recommend changes to management.

Disclaimer: This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.