RCMS Denials Analyst III

About this job

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.