RCMS AR Specialist I

Responsibilities

• Investigate and resolve complex denial issues.
• Analyze denial trends to identify areas for process improvement.
• Initiate and lead payer calls for escalated denial inquiries, follow-up and disputes.
• Develop and implement strategies to reduce denial rates and improve reimbursement.
• Collaborate with internal stakeholders to address root causes of denials.
• Mentor Level 1 is associate with advanced AR/Denial management techniques.
• Prepare and submit appeals for denied claims as needed.
• Maintain comprehensive documentation of denial activities and outcomes.

Requirements

• Associate degree in healthcare administration or related field (preferred).
• Proficiency in medical billing software and denial tracking systems.
• Strong problem-solving and analytical skills.
• Ability to effectively communicate with payers to negotiate claim resolutions.
• Leadership skills and ability to work independently.
• Attention to detail and accuracy in data analysis and reporting.

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