AR Specialist II
Summary
Handles complex healthcare claim denials, analyzes trends, negotiates with payers, and mentors junior staff to improve reimbursement rates.
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 & Denial rates and improve reimbursement.
- Collaborate with internal stakeholders to address root causes of denials.
- Mentor Level 1 associates on 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 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.
Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.