RCMS AR Specialist II

2 weeks ago

Vadodara, Gujarat, India Qualifacts Full time ₹ 4,00,000 - ₹ 8,00,000 per year

Job Description:

Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts' comprehensive portfolio, including the CareLogic, Credible, and InSync platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non-profit Certified Community Behavioral Health Clinics (CCBHC) as well as for-profit large enterprise and small business providers. Qualifacts has a loyal customer base, with more than 2,500 customers representing 75,000 providers serving more than 6 million patients.  Qualifacts was recognized in the 2022 and 2023 Best in KLAS: Software and Services report as having the top ranked Behavioral Health EHR solutions.

Responsibilities:

  • Investigate and resolve billing discrepancies and denials.

  • Analyze payer trends to identify areas for revenue improvement.

  • Prepare and submit appeals for denied claims.

  • Handle payer calls for escalated billing inquiries and disputes.

  • Monitor aging accounts receivable and follow up on overdue payments.

  • Train and mentor Level 1 associates on advanced billing procedures.

  • Generate and analyze reports to track key performance indicators.

  • Collaborate with cross-functional teams to implement process improvements.

Requirements:

  • Associate degree in healthcare administration or related field (preferred).

  • Minimum of 2 years of experience in medical billing or revenue cycle management.

  • Proficiency in medical billing software and coding systems (e.g., CPT, ICD-10).

  • Strong problem-solving and analytical skills.

  • Ability to prioritize tasks and manage time effectively.

  • Leadership skills and ability to work independently.

This is an onsite position, 5 days/week, in the Vadodara office working the NIGHT SHIFT. Hours are 6:30pm-3:30am IST. Remote applicants will not be considered. 

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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