Job
Description
As a Rejection Management Supervisor at Qualifacts, you will play a crucial role in ensuring the productivity and quality targets are met by supervising and mentoring a team of rejection specialists. Your responsibilities will include: - Supervising and mentoring a team of rejection specialists to ensure productivity and quality targets are achieved. - Monitoring team performance, conducting regular reviews, and implementing process improvements. - Collaborating with other RCM teams such as Billing, AR, and Denials to optimize claim processing efficiency. You will also be responsible for overseeing the analysis and resolution of rejections by: - Overseeing daily rejection reports and ensuring prompt resolution to prevent claim denials. - Identifying recurring rejection patterns and working with the team to implement corrective actions. Your role will involve analyzing rejection trends, providing recommendations to improve clean claim submission rates, and developing standard operating procedures (SOPs) for handling different types of rejections. You will work closely with billing, coding, and credentialing teams to minimize avoidable rejections. In terms of reporting and communication, you will: - Prepare and present rejection analysis reports, including root cause analysis and resolution strategies. - Maintain accurate documentation of rejection trends, team performance, and corrective actions taken. Qualifications and Requirements: - Education: Bachelor's degree preferred in Healthcare Administration, Business, or related field, or equivalent experience. - Experience: Minimum 3-5 years of experience in RCM medical billing, with at least 1-2 years in a supervisory role. - Technical Skills: Proficiency in EHR systems (e.g., Insync, Credible) and claim management software. - Analytical Skills: Ability to analyze rejection trends, identify root causes, and implement process improvements. - Problem-Solving: Strong problem-solving skills to efficiently resolve complex claim rejections. Preferred Qualifications: - Experience with automated rejection management tools. - Familiarity with EDI transactions (837, 835, 270, 271, 277, 999, etc.). - Knowledge of denial management and coordination with AR teams. Please note that Qualifacts is an equal opportunity employer that values diversity and is committed to creating an inclusive environment for all employees. As a Rejection Management Supervisor at Qualifacts, you will play a crucial role in ensuring the productivity and quality targets are met by supervising and mentoring a team of rejection specialists. Your responsibilities will include: - Supervising and mentoring a team of rejection specialists to ensure productivity and quality targets are achieved. - Monitoring team performance, conducting regular reviews, and implementing process improvements. - Collaborating with other RCM teams such as Billing, AR, and Denials to optimize claim processing efficiency. You will also be responsible for overseeing the analysis and resolution of rejections by: - Overseeing daily rejection reports and ensuring prompt resolution to prevent claim denials. - Identifying recurring rejection patterns and working with the team to implement corrective actions. Your role will involve analyzing rejection trends, providing recommendations to improve clean claim submission rates, and developing standard operating procedures (SOPs) for handling different types of rejections. You will work closely with billing, coding, and credentialing teams to minimize avoidable rejections. In terms of reporting and communication, you will: - Prepare and present rejection analysis reports, including root cause analysis and resolution strategies. - Maintain accurate documentation of rejection trends, team performance, and corrective actions taken. Qualifications and Requirements: - Education: Bachelor's degree preferred in Healthcare Administration, Business, or related field, or equivalent experience. - Experience: Minimum 3-5 years of experience in RCM medical billing, with at least 1-2 years in a supervisory role. - Technical Skills: Proficiency in EHR systems (e.g., Insync, Credible) and claim management software. - Analytical Skills: Ability to analyze rejection trends, identify root causes, and implement process improvements. - Problem-Solving: Strong problem-solving skills to efficiently resolve complex claim rejections. Preferred Qualifications: - Experience with automated rejection management tools. - Familiarity with EDI transactions (837, 835, 270, 271, 277, 999, etc.). - Knowledge of denial management and coordination with AR teams. Please note that Qualifacts is an equal opportunity employer that values diversity and is committed to creating an inclusive environment for all employees.
