Supervisor, RCMS

5 - 7 years

0 Lacs

Posted:1 day ago| Platform: Foundit logo

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Work Mode

Remote

Job Type

Full Time

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.

Key Responsibilities

  • Supervise daily AR operations for assigned clients/projects.
  • Monitor AR aging buckets and ensure timely follow-up on outstanding claims.
  • Drive resolution of denials (Authorization, Eligibility, Credentialing, Coding, etc.).
  • Ensure compliance with TAT, productivity, and quality SLAs.
Provide coaching, mentoring, and performance feedback to AR team members.
  • Coordinate with internal teams (Billing, Coding, Credentialing) to resolve issues.
  • Generate AR reports, highlight trends, and suggest process improvements.
  • Handle escalations and act as the first point of contact for clients.
  • Track KPIs such as AR days, aging %, denial rate, and collection efficiency.

Qualifications & Skills

  • Bachelor's degree in any field.
  • 57 years of experience in AR (Healthcare RCM), with at least 23 years in a supervisory/leadership role.
  • Strong understanding of US healthcare revenue cycle (payer policies, denials, AR follow-up).
  • Proficiency in MS Excel, AR dashboards, and reporting.
  • Excellent communication, leadership, and problem-solving skills.
  • Ability to manage multiple priorities and meet deadlines.

Key Performance Indicators (KPIs)

  • AR aging reduction (focus on 31180 days and 180+ buckets).
  • Denial resolution turnaround time.
  • % of claims resolved within TAT.
  • Team productivity and quality compliance.
  • Client satisfaction scores.

Preferred Experience

  • Experience working with EHR/EMR and AR management tools.
  • Prior exposure to client communication and project transition.
  • Experience in handling insurance-specific AR (Medicare, Medicaid, Commercial, MCOs).

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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