RCMS AR Specialist II

Job Description:

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).

·       Minimum of 2 years of experience in AR/Denial management or revenue cycle management.

·       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.