RCM Associate II

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.

Key Responsibilities

• Min 1-2 years of work experience in the same domain
• Handle more complex rejection cases that require in-depth analysis or investigation.
• Collaborate with billing specialists or healthcare providers to address systemic issues contributing to claim rejection.
• Develop and implement strategies to reduce claim rejection rates and improve overall revenue cycle efficiency.
• Provide training or guidance to Level 1 associates on resolving complex rejection issues.
• Participate in cross-functional teams or meetings to discuss process improvements and best practices.
  

Skills/Qualifications

• Associate's degree or equivalent experience in healthcare administration, medical billing, or a related field.
• Demonstrated experience in identifying root causes of claim rejection and implementing corrective actions.
• Proficiency in using advanced features of billing software or analytical tools for data interpretation.
• Ability to prioritize tasks and manage multiple projects simultaneously.
• Strong problem-solving and decision-making skills.
  

Experience Required:

Minimum 12 years of work experience in the same domain (RCM Rejection/AR/Denial Management).

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.