Job Description:

Responsibilities

• Investigate and resolve complex AR/denial issues.

• Analyze denial trends to identify areas for process improvement.

• Initiate and lead payer calls for escalated denial inquiries and disputes.

• Develop and implement strategies to reduce aging and denial rates while improving reimbursement.

• Collaborate with internal stakeholders to address root causes of denials.

• Mentor Level 1 associates in 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 a related field (preferred).

• Minimum of 1.5 years’ experience in denial management or revenue cycle management.

• Proficiency in medical billing software and denial-tracking systems.

• Strong problem-solving and analytical skills.

• Ability to communicate effectively with payers to negotiate claim resolutions.

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