RCMS Denials Analyst II

Responsibilities

• Investigate and resolve complex denial issues.
• Analyze denial trends to identify opportunities for process improvement.
• Initiate and lead payer calls for escalated denial inquiries, follow-ups, and disputes.
• Develop and implement strategies to reduce denial rates and enhance reimbursement.
• Collaborate with internal stakeholders to address root causes of denials.
• Prepare and submit appeals for denied claims as needed.
• Maintain comprehensive documentation of denial activities and outcomes.
• Address denials at the root cause by requesting appropriate rules and system edits after partner approval.
• Identify and analyze denial trends and escalate to supervisor for further resolution.

Requirements

• Bachelor's degree in any discipline.
• Strong problem-solving and analytical skills and work towards resolution.
• Candidates with 1-2 years of experience in Accounts Receivable (AR) & Denial Management
• Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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Company Intel

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