RCMS Denials Analyst III

Qualifacts Systems Inc.; Vadodara; On-site; INR 1,500,000 - 2,500,000; Full time

Job summary

Qualifacts Systems Inc. in Vadodara seeks an experienced AR/Denials Manager to lead escalated billing issues and payer disputes, while driving revenue cycle improvements and compliance.

You will manage complex payer calls, mentor junior staff, track KPIs, and collaborate with leadership to optimize processes, data reporting, and stakeholder communication.

Qualifications

• Bachelor's 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.

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

Communication

Data analysis

Stakeholder management

Mentoring

Problem solving

Decision making

Education

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

Job description

Job Description:

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

• Bachelor's 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.