RCMS Denials Analyst III

Qualifacts Systems; Vadodara; On-site; INR 900,000 - 1,500,000; Full time

Job summary

Qualifacts Systems in Vadodara, India, seeks an experienced AR/Denials Manager to lead escalated billing issues, payer disputes, and revenue cycle optimization. The role focuses on team mentoring, process improvements, and ensuring regulatory compliance.

You will manage complex inquiries, develop KPIs, and partner with leadership to drive accuracy, efficiency, and strong stakeholder relationships in a dynamic healthcare billing environment.

Qualifications

• Bachelor's degree in Healthcare Administration, Finance, or related field.
• Minimum 5 years of progressive AR/Denials Management experience.
• Strong knowledge of healthcare billing regulations, payer guidelines, and compliance standards.
• Proven leadership, coaching, and mentoring abilities.
• Excellent communication, presentation, and stakeholder management skills.
• Proficiency in data analysis, reporting, and performance-tracking tools.
• Ability to drive process improvements and implement change effectively.
• Strong analytical, problem-solving, and decision-making capabilities.

Responsibilities

• Lead the resolution of escalated billing issues and payer disputes.
• Manage payer calls for complex billing inquiries, negotiations, and dispute resolution.
• Develop and implement strategies to improve revenue cycle efficiency and effectiveness.
• Conduct regular audits to ensure billing accuracy and compliance.
• Provide training, mentorship, and ongoing support to junior associates and team members.
• Collaborate with leadership to develop, track, and monitor KPIs.
• Stay updated on industry trends, regulatory changes, and revenue cycle management best practices.

Skills

Leadership

Mentoring

Communication

Data analysis

Stakeholder management

Process improvement

Regulatory knowledge

Problem solving

Education

Bachelor's degree in Healthcare Administration, Finance, or related field

Job description

Responsibilities

• Lead the resolution of escalated billing issues and payer disputes.
• Manage payer calls for complex billing inquiries, negotiations, and dispute resolution.
• Develop and implement strategies to improve revenue cycle efficiency and effectiveness.
• Conduct regular audits to ensure billing accuracy and compliance.
• Provide training, mentorship, and ongoing support to junior associates and team members.
• Collaborate with leadership to develop, track, and monitor key performance indicators (KPIs).
• Stay updated on industry trends, regulatory changes, and revenue cycle management best practices.

Requirements

• Bachelors degree in Healthcare Administration, Finance, or a related field.
• Minimum 5 years of progressive experience in AR/Denials Management
• Strong knowledge of healthcare billing regulations, payer guidelines, and compliance standards.
• Proven leadership, coaching, and mentoring abilities.
• Excellent communication, presentation, and stakeholder management skills.
• Proficiency in data analysis, reporting, and performance-tracking tools.
• Ability to drive process improvements and implement change effectively.
• Strong analytical, problem-solving, and decision-making capabilities.

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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.