RCMS AR Specialist

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 :

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.

Education

Bachelor of Music, Bachelor of Arts (B.A), Bachelor of Architecture (B.Arch), Bachelor of Science (B.Sc), Bachelor of Interdisciplinary Studies, Bachelor of Health Science, Bachelor Of Technology (B.Tech / B.E), Bachelor of Education (B.Ed), Bachelor of Music Education (B.M.E.), Bachelor in General Studies (BGS), Bachelor in Hotel Management (B.H.M), Bachelor of Liberal Arts (BLA / ALB), Bachelor of Homeopathic Medicine and Surgery (BHMS), Bachelor of Business Administration (B.B.A), MBBS, Bachelor of Applied Science (BAS), Bachelor Of Pharmacy (B.Pharm), Bachelors of Law (B.L / L.L.B), Bachelor of Commerce (B.Com), Bachelor Of Computer Application (B.C.A), Bachelor of Dental Surgery (B.D.S), Bachelor of Ayurvedic Medicine and Surgery (BAMS), Bachelor of Social Work (B.S.W)

Skills Required

Rcm, Ar Calling, Us Healthcare, Medical Billing