RCMS Associate I

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.