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RCMS Associate I at Qualifacts Systems LLC

Vadodara, gujarat, India -

Full Time

Start Date

Immediate

Expiry Date

26 Dec, 25

Salary

0.0

Posted On

27 Sep, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Attention To Detail, Analytical Skills, Communication Skills, Medical Terminology, Coding Systems, Insurance Billing Processes, Software Proficiency

Industry

Software Development

Description

Job Description: Review and analyze rejected claims or invoices. Identify the reasons for claim rejection, such as coding errors, missing information, or billing discrepancies. Communicate with internal departments or external parties to resolve issues causing claim rejection. Update databases or software with accurate information regarding rejected claims and their resolution status. Assist in the preparation of reports summarizing rejection trends and areas for improvement. Skills/Qualifications: Graduate or equivalent; additional education or certification in healthcare administration or medical billing may be preferred. Basic understanding of medical terminology, coding systems (e.g., ICD-10, CPT), and insurance billing processes. Proficiency in using relevant software or databases for claim management and analysis. Strong attention to detail and analytical skills. Effective communication skills for interacting with team members and external stakeholders. Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. For more than 20 years, Qualifacts has delivered thoughtful innovation, technology, support, and services to the behavioral health and human services market. Most recently, Qualifacts has been on a mission to expand its portfolio to support the patient continuum, from the initial appointment request to final billing and reporting, and everything in between. Qualifacts has headquarters in Nashville and Tampa with employees across the globe, many with strong healthcare and clinical backgrounds to help bring you the best solutions possible.

Responsibilities

The RCMS Associate I will review and analyze rejected claims or invoices, identifying reasons for rejection and communicating with relevant parties to resolve issues. They will also update databases with accurate information and assist in preparing reports on rejection trends.