Job Description:
Responsibilities:
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Investigate and resolve complex denial issues.
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Analyze denial trends to identify opportunities for process improvement.
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Initiate and lead payer calls for escalated denial inquiries, follow-ups, and
disputes.
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Develop and implement strategies to reduce denial rates and enhance
reimbursement.
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Collaborate with internal stakeholders to address root causes of denials.
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Prepare and submit appeals for denied claims as needed.
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Maintain comprehensive documentation of denial activities and outcomes.
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Address denials at the root cause by requesting appropriate rules and system
edits after partner approval.
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Identify and analyze denial trends and escalate to supervisor for further
resolution.
Requirements:
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Bachelor’s degree in any discipline.
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Strong problem-solving and analytical skills and work towards resolution.
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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.
