Job Description: Responsibilities for the Sr. Support Specialist I Provide technical support to customers by researching and answering questions, troubleshooting problems, and optimizing software performance Provide outstanding customer service, including timely, concise, and accurate responses, and proactive customer issue management, while handling all customer requests in a professional, positive, and dignified manner Provide training and consultation Develop knowledge in other domain areas Begin working within additional service offerings (Live Chat, Concierge, Phone Line) and participating in NRR-based projects (LOE/SOW) Effectively communicate (verbal, listening, and written) with team, leadership, and customers Create a positive team environment with motivation and energy Gain and maintain the trust and confidence of team members by demonstrating integrity, accountability, and flexibility Utilize clearing house to process claims Work claims within a 24-hour time period Identify rejection trends and work towards reducing them for customers Work with managed care networks and insurance carriers to process claims Resolve moderate to high complexity/priority requests with consistent quality Please Note: - Location: -Vadodara, Gujarat (Work from Office only) Shift: -US/Night Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Description: Responsibilities: Develop and optimize compliance reporting software, ensuring high performance, security, and maintainability. Collaborate closely with Product Owners to shape requirements, refine technical specifications, and assess feasibility. Contribute to architectural discussions, ensuring software solutions align with best practices and long-term system sustainability. Independently take ownership of projects, proactively identifying potential risks and driving solutions to completion. Mentor and support lower-level developers, providing code reviews, sharing best practices, and offering guidance when needed. Drive debugging and performance optimization efforts, identifying and resolving bottlenecks in applications and databases. Ensure compliance with coding standards, security protocols, and documentation best practices. Work closely with QA, other engineers, and operations to support smooth releases and system stability. Knowledge, Skills Abilities: Required: Advanced debugging and performance optimization skills, with the ability to analyze complex system issues and improve efficiency. Strong architectural and design understanding, ensuring scalability, security, and maintainability. Ability to translate business needs into technical solutions, assisting Product Owners in refining requirements and identifying the best approaches. Proficiency in Microsoft SQL Server, including query optimization. Deep expertise in .NET technologies, including .NET Core, C#, and SaaS application development. Expertise in designing, consuming, and integrating APIs and web services, including RESTful and SOAP APIs. Extensive experience with source control best practices in collaborative development environments (preferably Git). Ability to mentor and guide junior developers, providing technical support and promoting best practices. Self-motivated and capable of working independently, taking responsibility for projects and ensuring successful outcomes. Preferred: In-depth understanding of data interchange formats, such as ANSI X12, CSV, HL7, JSON, and XML. Experience with front-end technologies, including CSS, JavaScript, jQuery, and Angular. Proven experience in Agile/Scrum environments, actively contributing to process improvements and sprint success. Experience deploying and managing applications in AWS, including knowledge of AWS services, architecture, and best practices. Hands-on experience with Azure DevOps, including Pipelines, Repositories, and Work Items. Nice to Have: Familiarity with SQL Server Reporting Services (SSRS). Proficiency in HL7 FHIR and healthcare data integration. Understanding of healthcare compliance regulations and reporting standards. Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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. If you want to work inside an atmosphere where innovation has purpose, and your ambition works to support our customers and those they serve, please apply today! 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. Summary of the Director, RCMS India Operations The Director of Revenue Cycle Management (RCM) will be responsible for leading and optimizing end-to-end revenue cycle operations for the company s US-based healthcare clients. This role requires deep expertise in US healthcare RCM processes, including medical billing, coding, insurance claims, accounts receivable (A/R) management, denials management, and compliance. The Director will drive process efficiency, ensure regulatory adherence, implement automation solutions, and lead a high-performing team to achieve revenue and operational goals. Responsibilities for the Director, RCMS India Operations Strategic Leadership Operations Oversee and manage the entire revenue cycle function, including charge capture, billing, prior-authorization, collections, and payment posting Develop and implement best practices, policies, and workflows to optimize revenue cycle performance and ensure compliance with US healthcare regulations Collaborate with US-based stakeholders, including providers, payers, and leadership teams, to align RCM strategies with business goals Drive automation and process improvement initiatives leveraging technology, analytics, and AI-driven solutions Team Management Performance Optimization Lead, mentor, and develop a team of RCM professionals, including medical billers, payment posting specialists, and A/R follow-up analysts Set performance metrics, monitor KPIs, and ensure achievement of key revenue cycle objectives, such as reducing A/R days and improving collection rates Foster a culture of accountability, continuous learning, and process excellence within the team Revenue Compliance Management Ensure compliance with US healthcare laws, including HIPAA, CMS guidelines, and payer regulations Analyze revenue cycle trends, identify revenue leakage, and implement corrective actions to improve financial outcomes Develop and maintain strong payer relationships to optimize reimbursement and resolve claim disputes. Technology Process Improvement Partner with technology teams to implement and optimize RCM tools, EHR systems, and automation solutions. Leverage data analytics and reporting to drive decision-making and enhance revenue cycle performance. Stay updated on industry trends, regulatory changes, and emerging technologies in healthcare RCM. Qualifications of the Director, RCMS India Operations Advanced degree in Business Administration, Healthcare Management, Finance, or a related field Minimum 12+ years of experience in US healthcare RCM, with at least 5+ years in a senior leadership role Expertise in US Healthcare RCM and a strong knowledge of medical billing, coding (CPT, ICD-10, HCPCS), payer regulations, claims adjudication, and reimbursement methodologies (Medicare, Medicaid, commercial payers) Proven experience in managing large RCM teams and driving performance improvements. Experience with EHR/RCM systems (Qualifacts, Epic, Cerner, Athenahealth, NextGen, etc.) and automation tools like RPA/AI in RCM processes. Knowledge, Skills, and Abilities of the Director, RCMS India Operations Strong ability to problem solve, analyze revenue cycle data, identify trends, and implement process enhancements Deep understanding of HIPAA, CMS guidelines, and payer-specific policies for compliance and regulatory purposes Excellent communication and stakeholder management and the ability to work with US-based leadership, clients, and cross-functional teams. Certifications such as Certified Revenue Cycle Representative (CRCR), Certified Professional Coder (CPC), or Certified Revenue Cycle Executive (CRCE), preferred Experience in healthcare technology firms, BPO/KPO, or RCM service providers catering to US healthcare clients, preferred Dynamic and collaborative work environment with exposure to global healthcare markets, preferred Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Description: Configure and customize the EHR system according to specifications provided by the Implementation Specialist, Project Coordinators, CSM and Vendor, including clinical workflows, templates, order sets, and other clinical configurations. Ensure that all configurations align with industry standards, regulatory guidelines (such as HIPAA), and best practices in healthcare IT. Developing Knowledge: Seeks less guidance; comfortable analyzing facts and making decisions but keeps supervisor informed and involved as appropriate; Adherence to Ticket Productivity goals and SLA/SLO requirements; Resolve moderate to high complexity/priority requests with consistent quality. Clearly understands customer business needs and formulates accurate resolutions in addressing the customer needs and proactively assists teammates with request resolutions. Breakdown of tasks per type (nomenclature dependent on ticketing solution): Low complexity/priority tasks: 25% Moderate/High complexity/priority tasks: 75% Seeks less guidance; Resolve moderate to high complexity/priority requests with consistent quality. Maintains customer records by updating account information in CRM. Communicate or connect frequently with the client to understand their requirement, and data gathering, and close the task once completed. Complete all the assigned tickets on a timely and accurate quality assurance. Effectively communicates (Verbal, Listening, and Written) with team, leadership, and Implementation Specialist, Project Coordinators, CSM and Vendor; Ability to ask probing questions based on effective listening. Creates a positive team environment with motivation and energy. Gains and maintains the trust and confidence of team members by demonstrating integrity, accountability, and flexibility. Proactively assists teammates with request resolutions. Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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. If you want to work inside an atmosphere where innovation has purpose, and your ambition works to support our customers and those they serve, please apply today! 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. Responsibilities for the Desktop Support Tech I Provide hardware and software support for both remote and office users Provide direct service for IT networks Maintain a work log of job tickets and maintenance tasks Stay updated on new developments in, and analyze reviews of, computing technologies Maintain and manage Active Directory including set up of new users, Administer Azure, and Office 365 environments Assist team with Corporate IT projects Develop and maintain the software application configurations, including documentation of IT operation runbook Work closely with other roles to research new tools and technologies that can better support business needs Effectively communicate issues to both technical and non-technical stakeholders Collaborate on one or more projects Qualifications of the Desktop Support Tech I Higher Secondary Certificate (HSC) or Senior Secondary Certificate (SSC) 1 to 2 years of related experience including: 2+ years working with Windows Desktop Operating Systems 1+ years working with Microsoft Active Directory 1+ years as a system administrator / Helpdesk Support Technician 1+ years working with Microsoft Office 365 Administration Experience in Microsoft Office Suite Basic troubleshooting skills and problem solving Knowledge, Skills, and Abilities of the Desktop Support Tech I Excellent troubleshooting expertise and enthusiastic problem solver Excellent attention to detail including precise and effective communications and proven ability to manage multiple, competing priorities simultaneously Determined to succeed Approachable, open, and consultative Exceptional customer service Diplomatic, but firm Has little or no role in decision-making but will be asked to propose and discuss solutions Expected to collaborate and interact with team members and employees outside of the IT organization Must be comfortable discussing and debating technical and softskill situations to learn and grow Work on assignments that are routine in nature, requiring limited judgment Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Description: Roles and Responsibilities Act as the Single P oint of C ontact (SPOC) for both commercial and assigned customer representations which can include System Administrators or other authorized users. Responsible for management of all commercial relationship items including pricing negotiation, renewals , M A and expansion. Responsible for key administrative tasks including Salesforce administration , data integrity, reporting and forecasting. Respond to general escalations and coordinate with other key business stakeholders to resolve issues Maintain engagement within assigned accounts while enga ging in C ustomer relationship building to increase Customer Champion/Referral program. Develop expanded business opportunities by analyzing account potential, initiating , developing, and closing sales. Develop sales by making an initial presentation; explaining product and service enhancements and additions; introducing new products and services. Qualifications 1-year professional experience required in sales and/or account management or 3 years customer relationship management experience in another customer-facing sales or service role Bachelor s degree preferred Proven performance in achieving KPIs Must be able to build effective customer relationships Must be a team player Strong problem-solving abilitie s , conflict resolution, time management and attention to detail are a must Strong communication skills both verbal and written Professional English-Speaking Skills Proficiency in Microsoft Suite Ability to work in fast paced environment and meet SLA deadlines Detail and process oriented with accuracy focus and organization Customer first mindset and ability to interface visually, verbally and written Will be required to work U.S. hours Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Description: Roles and Responsibilities Act as the Single P oint of C ontact (SPOC) for both commercial and assigned customer representations which can include System Administrators or other authorized users. Responsible for management of all commercial relationship items including pricing negotiation, renewals , M A and expansion. Responsible for key administrative tasks including Salesforce administration , data integrity, reporting and forecasting. Respond to general escalations and coordinate with other key business stakeholders to resolve issues Maintain engagement within assigned accounts while enga ging in C ustomer relationship building to increase Customer Champion/Referral program. Develop expanded business opportunities by analyzing account potential, initiating , developing, and closing sales. Develop sales by making an initial presentation; explaining product and service enhancements and additions; introducing new products and services. Qualifications 1-year professional experience required in sales and/or account management or 3 years customer relationship management experience in another customer-facing sales or service role Bachelor s degree preferred Proven performance in achieving KPIs Must be able to build effective customer relationships Must be a team player Strong problem-solving abilitie s , conflict resolution, time management and attention to detail are a must Strong communication skills both verbal and written Professional English-Speaking Skills Proficiency in Microsoft Suite Ability to work in fast paced environment and meet SLA deadlines Detail and process oriented with accuracy focus and organization Customer first mindset and ability to interface visually, verbally and written Will be required to work U.S. hours Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Description: Responsibilities: Serve as an AR/Denial Specialist , billing regulations and compliance requirements. Lead the resolution of escalated billing issues and payer disputes. Lead payer calls for complex billing inquiries, negotiations, and dispute resolutions. Develop and implement strategies to improve revenue cycle efficiency and effectiveness. Conduct regular audits to ensure accuracy and compliance in billing processes. Provide training and ongoing support to junior associates and other team members. Collaborate with leadership to develop and monitor key performance indicators. Stay current on industry trends and best practices in revenue cycle management. Requirements: Bachelors degree in healthcare administration, finance, or related field. Minimum of 5 years of progressive experience in medical billing or revenue cycle management. In-depth knowledge of healthcare billing regulations and compliance standards. Strong leadership and mentoring skills. Excellent communication and presentation abilities. Proficiency in data analysis and reporting tools. Ability to drive change and implement process improvements effectively. Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Description: Investigate and resolve complex denial issues. Analyze AR/Denial trends to identify areas for process improvement. Initiate and lead payer calls for escalated denial inquiries and disputes. Develop and implement strategies to reduce denial rates and improve reimbursement. Collaborate with internal stakeholders to address root causes of denials. Mentor Level 1 associates on advanced denial management techniques. Prepare and submit appeals for denied claims as needed. Maintain comprehensive documentation of denial activities and outcomes. Requirements: Associate degree in healthcare administration or related field (preferred). Minimum of 2 years of experience in AR/Denial management or revenue cycle management. Proficiency in medical billing software and denial tracking systems. Strong problem-solving and analytical skills. Ability to effectively communicate with payers to negotiate claim resolutions. Leadership skills and ability to work independently. Attention to detail and accuracy in data analysis and reporting. Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Description: Summary We are seeking an experienced and dynamic profession for Quality Engineering (Automation) to lead our Quality Engineering team in India. As a senior engineer , you will oversee the Quality Engineering (Automation) function and play a pivotal role in ensuring the quality of our web-based Electronic Health Record (EHR) system. You will be responsible for driving automation efforts, improving testing processes, and maintaining a strong focus on automated testing. If you have a strong background in automated testing, and are an expert in Selenium, we want to hear from you. Key Responsibilities: (Mandatory): QA Automation (Selenium), Automation Frameworks, Team Leadership, Test Planning , Agile/Scrum, DevOps Basic Workflow Understanding, Test Strategy Handle the Quality Engineering (Automation) team, providing guidance, mentorship, and leadership to ensure the teams success. Define and implement the automation strategy and roadmap, emphasizing the use of Selenium, while ensuring efficient manual testing practices Collaborate with cross-functional teams to identify automation opportunities, define test requirements, and prioritize test cases for automation Develop and maintain automated test scripts, test suites, and test frameworks to ensure efficient and comprehensive test coverage Establish and maintain best practices for test automation, including code standards, version control, continuous integration and maximize test coverage. Lead the creation of test plans and test strategies, ensuring alignment with Agile/Scrum development processes Monitor and report on automation progress, test coverage, and test results to stakeholders, making data-driven decisions to improve quality Expertise in Selenium for test automation, including designing and implementing automation frameworks Proficiency in Agile/Scrum methodologies working in cross-functional teams Familiarity with test management and defect tracking tools Excellent problem-solving and analytical skills, with a keen attention to detail Support team on troubleshooting for complex scenarios, suggest and amend framework to handle challenges Effective communication and leadership skills, with the ability to collaborate with technical and non-technical stakeholders Stay abreast of emerging trends, technologies, and best practices in test automation, and make recommendations for adoption as appropriate . Collaborate with software development teams to integrate automated testing into the CI/CD pipeline and ensure timely execution of tests. Requirements: Bachelors D egree in Computer Science , Software Engineering, or a related field 8 + years of experience in Quality Assurance (QA) with a strong focus on automated testing Proven expertise in designing, developing, and implementing automated test frameworks and test scripts using Selenium WebDriver and related technologies. Strong programming skills in languages such as Java, Python, or C#. Proven expertise in designing, developing, and implementing automated test frameworks and test scripts using Selenium WebDriver and related technologies. Strong programming skills in languages such as Java, Python, or C#. Proven track record of leading and mentoring automation QA teams in a fast-paced, dynamic environment. Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Description: Configure and customize the EHR system according to specifications provided by the Implementation Specialist, Project Coordinators, CSM and Vendor, including clinical workflows, templates, order sets, and other clinical configurations. Ensure that all configurations align with industry standards, regulatory guidelines (such as HIPAA), and best practices in healthcare IT. Developing Knowledge: Seeks less guidance; comfortable analyzing facts and making decisions but keeps supervisor informed and involved as appropriate; Adherence to Ticket Productivity goals and SLA/SLO requirements; Resolve moderate to high complexity/priority requests with consistent quality. Clearly understands customer business needs and formulates accurate resolutions in addressing the customer needs and proactively assists teammates with request resolutions. Breakdown of tasks per type (nomenclature dependent on ticketing solution): Low complexity/priority tasks: 25% Moderate/High complexity/priority tasks: 75% Seeks less guidance; Resolve moderate to high complexity/priority requests with consistent quality. Maintains customer records by updating account information in CRM. Communicate or connect frequently with the client to understand their requirement, and data gathering, and close the task once completed. Complete all the assigned tickets on a timely and accurate quality assurance. Effectively communicates (Verbal, Listening, and Written) with team, leadership, and Implementation Specialist, Project Coordinators, CSM and Vendor; Ability to ask probing questions based on effective listening. Creates a positive team environment with motivation and energy. Gains and maintains the trust and confidence of team members by demonstrating integrity, accountability, and flexibility. Proactively assists teammates with request resolutions.

Job Description: We are seeking an experienced Insurance Authorization Specialist II who will be responsible for obtaining and managing insurance authorizations for various procedures, treatments, and services, including retro authorizations. This role involves working closely with insurance companies and providers to secure prior approvals, resolve authorization issues, and submitting appeals when retro authorizations are required in a timely manner. Specialist will use expertise and communicate with the payer and provider to reduce claim denials and ensure that provider services are reimbursed in full. Key Responsibilities: Obtain and Manage Authorizations : Secure prior authorizations for medical procedures, treatments, and services as required by insurance providers, including retroactive authorizations. Collaboration : Work with insurance companies, providers, and billing teams to ensure all required authorizations are obtained prior to services being rendered and claims being submitted. Data Management: The position requires Excel knowledge to maintain and create reports of authorization levels, track trends, and analyze data to ensure efficient and accurate reporting. Appeals Process : Support the appeals process for denied claims, particularly for cases involving retroactive authorization requests. This includes gathering the necessary documentation and submitting appeals to insurance providers. Communication: The role requires participating in calls and emails with both clients and insurance companies to set up and streamline workflows, ensuring smooth integration of authorization processes. Process Improvement : Identify opportunities to streamline authorization processes and reduce delays, contributing to more efficient claim submissions and better reimbursement outcomes. Team Support : Collaborate with team members Authorization, billing and provider relations, to ensure that all authorization processes align with organizational goals. Qualifications: Experience: Minimum of 1-2 years of experience in insurance authorization with a working knowledge of insurance procedures and authorization processes. Knowledge : In-depth understanding of insurance Authorization guidelines, authorization processes. Excel Skills : Advanced proficiency in Microsoft Excel, including the ability to create and manage spreadsheets, use pivot tables, formulas to analyze and report data. Experience in tracking authorization data and generating reports is a must. Communication Skills: Strong verbal and written communication skills are crucial for effectively coordinating with Payer, US team and provider, ensuring that authorization processes are clear, issues are promptly addressed, and workflows run smoothly. PLEASE NOTE Work from Office only (Location: -Vadodara, Gujarat) US/Night Shift

Job Description: We are seeking an experienced Insurance Authorization Specialist III who will be responsible for obtaining and managing insurance authorizations for various procedures, treatments, and services, including retro authorizations. This role involves working closely with insurance companies and providers to secure prior approvals, resolve authorization issues, and submitting appeals when retro authorizations are required in a timely manner. Specialist will use expertise and communicate with the payer and provider to reduce claim denials and ensure that provider services are reimbursed in full. Key Responsibilities: Obtain and Manage Authorizations : Secure prior authorizations for medical procedures, treatments, and services as required by insurance providers, including retroactive authorizations. Collaboration : Work with insurance companies, providers, and billing teams to ensure all required authorizations are obtained prior to services being rendered and claims being submitted. Data Management: The position requires Excel knowledge to maintain and create reports of authorization levels, track trends, and analyze data to ensure efficient and accurate reporting. Appeals Process : Support the appeals process for denied claims, particularly for cases involving retroactive authorization requests. This includes gathering the necessary documentation and submitting appeals to insurance providers. Communication: The role requires participating in calls and emails with both clients and insurance companies to set up and streamline workflows, ensuring smooth integration of authorization processes. Process Improvement : Identify opportunities to streamline authorization processes and reduce delays, contributing to more efficient claim submissions and better reimbursement outcomes. Team Support : Collaborate with team members Authorization, billing and provider relations, to ensure that all authorization processes align with organizational goals. Qualifications: Experience: Minimum of 2-3 years of experience in insurance authorization with a working knowledge of insurance procedures and authorization processes. Knowledge : In-depth understanding of insurance Authorization guidelines, authorization processes. Excel Skills : Advanced proficiency in Microsoft Excel, including the ability to create and manage spreadsheets, use pivot tables, formulas to analyze and report data. Experience in tracking authorization data and generating reports is a must. Communication Skills: Strong verbal and written communication skills are crucial for effectively coordinating with Payer, US team and provider, ensuring that authorization processes are clear, issues are promptly addressed, and workflows run smoothly. Please Note: - Work From Office only (Location: -Vadodara, Gujarat) Shift: -US/Night

Qualifacts Systems, Inc. is looking for Manager, Agile Practice to join our dynamic team and embark on a rewarding career journey. Manager, Agile Practice is responsible for overseeing and optimizing manager, agile practice operations. This role involves strategic planning, team coordination, and execution of tasks to ensure efficiency and productivity. The incumbent will collaborate with stakeholders to align operations with business goals. Duties include monitoring performance, ensuring compliance with policies, and implementing best practices. Additionally, they will manage resources, resolve operational challenges, and contribute to continuous improvement initiatives. Strong analytical skills, leadership abilities, and industry knowledge are essential for success in this role.

Provide technical support to Clinical Implementation Specialists (CIS), Billing Implementation Specialists (BIS), and customers by configuring requested tasks within the system. This includes setting up requested tools and delivering client training. Conduct research, address inquiries, troubleshoot issues, and enhance software performance through various tasks. Deliver exceptional customer service by providing timely, concise, and accurate responses, while proactively managing customer issues and handling requests in a professional, positive manner. Resolve low to moderate complexity requests with a focus on quality. Communicate effectively (verbal, listening, and written) with team members, leadership, and customers. Foster a collaborative team environment, engaging others with critical thinking and a positive attitude. Build a reputation for reliability by consistently upholding commitments. Minimum Qualifications: A Bachelors degree is preferred; however, a High School diploma with relevant EHR/software customer service or behavioral health agency experience may substitute for the undergraduate degree. At least 1 year of experience with EHR software. Exceptional written and verbal communication skills in English. Proficient in Microsoft Office Suite. Quick to acquire and adapt to new skills. Strong attention to detail and follow - through skills Strong organization and time management skills. Proficient typing skills. Knowledge/Application Developing Knowledge: You will make informed decisions with guidance from your manager, supervisor, and senior staff, and know when to seek assistance for escalation. You will meet productivity goals and adhere to SLA/SLO requirements while resolving low to moderate complexity requests with consistent quality. Understanding customer business needs is essential, and you will collaborate with management and senior staff to formulate effective resolutions. Task Management: You will be responsible for handling low and moderate complexity tasks effectively.

Job Description: Responsibilities for the Software Engineer II: Develop software solutions and deliver product enhancements Troubleshoot software applications, provide technical support to achieve development objectives Participate in the design and development of complex web-based EHR systems Assist/Help Architect scalable and high-performance solutions, ensuring the best practices in software design and coding standards are followed Collaborate with cross-functional teams to define technical requirements and ensure timely delivery of software solutions Participate in Agile/Scrum methodologies, including sprint planning, backlog grooming, and retrospective meetings Stay updated with emerging technologies, industry trends, and best practices, and contribute to the continuous improvement of the development process Qualifications of the Software Engineer II: Bachelors degree required (computer science, information systems, business administration or another industry-related curriculum) 5+ or more years as full stack developer along with experience in web applications, end-user applications and back-end services Technical Skills of the Software Engineer II: Languages: .NET, C#, JavaScript, SQL, .Net Core Frameworks: MVC, .NET Entity Framework, React Databases: MS SQL, DynamoDB (or other NoSQL DB), Mongo DB Cloud: AWS (or equivalent cloud frameworks) Cloud-hosted, scalable SaaS systems Experience with serverless architectures (e.g. AWS Lambda, Event Bridge, API Gateway) Experience providing software troubleshooting and enhancements to existing system and applications Experience developing RESTful APIs (or equivalent) Experience with Agile methodologies Source control management, preferably git Secure coding practices Knowledge, Skills, and Abilities of the Software Engineer II: Customer focused, driven to help our customers Keen sense of priority and urgency Passionately committed to engineering best practices Self-learner and problem solver Accountability and Ownership Additional Job Description: This position, based at Vadodara, Gujarat, requires work from office. Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Description: JOB DESCRIPTION Responsible for supervising the team to work on assigned cases Monitor Teams production and SLA delivery Keep a record of client KPIs and teams performance against the KPIs Monitor the issue logs raised by the client partners and review each issue log prior to being escalated to the customer Provide subject matter expertise on Accounts Receivable processes Manage and handle effectively escalations raised by the clients Provide mentorship, training and coaching to the team Adhere to organizational policies and procedures Lead by example by demonstrating the highest standards of ethical behavior Monitoring and reporting team performance as needed Keep the Standard Operating Procedures updated and establish due control mechanisms Work with quality and business transformation team to identify, recommend and implement process improvement projects JOB REQUIREMENTS To be considered for this position, applicants need to meet the following qualification criteria: 5 to 8 years of revenue cycle service delivery management experience Account team leadership experience leading 10-20+ individuals Demonstrated expertise in problem-solving and revenue cycle transformation (for e.g. improvement in % of collections, growth of the client account team size etc.) Performance record of achievement with great people management & leadership skills Strong knowledge of US revenue cycle management for Physician Practices and Hospitals Proven track record in problem solving and improving process efficiency through strong analytical and problem solving skills Excellent written & verbal communication skills Strong leadership skills with an ability to motivate direct reports Develop the teams talent, drive employee retention and engagement PLEASE NOTE: - Work from Office only, (Location: -Vadodara, Gujarat) US Shift/Night Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Description: Responsibilities: Investigate and resolve complex denial issues. Analyze denial trends to identify areas for process improvement. Initiate and lead payer calls for escalated denial inquiries, follow-up and disputes. Develop and implement strategies to reduce denial rates and improve reimbursement. Collaborate with internal stakeholders to address root causes of denials. Mentor Level 1 is associate with advanced AR/Denial management techniques. Prepare and submit appeals for denied claims as needed. Maintain comprehensive documentation of denial activities and outcomes. Requirements: Associate degree in healthcare administration or related field (preferred). Minimum of 2 years of experience in AR/Denial management or revenue cycle management. Proficiency in medical billing software and denial tracking systems. Strong problem-solving and analytical skills. Ability to effectively communicate with payers to negotiate claim resolutions. Leadership skills and ability to work independently. Attention to detail and accuracy in data analysis and reporting. PLEASE NOTE Work from Office only (Location: -Vadodara, Gujarat) US/Night Shift Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Description: Responsibilities: Investigate and resolve complex denial issues. Analyze denial trends to identify opportunities for process improvement. Initiate and lead payer calls for escalated denial inquiries, follow-ups, and disputes. Develop and implement strategies to reduce denial rates and enhance reimbursement. Collaborate with internal stakeholders to address root causes of denials. Prepare and submit appeals for denied claims as needed. Maintain comprehensive documentation of denial activities and outcomes. Requirements: Associate degree in healthcare administration or a related field (preferred). Minimum of 2 years of experience in AR/Denial management or revenue cycle management. Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Description: Duties and Responsibilities Review formatted data for invoicing. Generate invoices for all service types and frequencies. QA invoicing prior to finalization. Create revenue dashboards to analyze trends at the customer and product level. Process credit memos and reconcile customer accounts as appropriate. Reconcile deferred revenue schedules. Work collaboratively with contracts and other customer operations departments Work collaboratively with IT to ensure data accuracy (for data used to invoice) Identify anomalies in data trends and research discrepancies. Troubleshoot issues that may lead to errors. Assist with Training Staff Accountant Assist with collections and cash reporting Ad hoc projects Requirements Strong knowledge of customer contracts and invoicing process Strong understanding of accounting as it relates to revenue and related concepts. Strong knowledge of systems used during the invoicing process. Bachelors degree in accounting, preferred. 5 years of accounting experience Responsibilities for the Sr Accountant Revenues, I Extract, manipulate and combine data from multiple systems, sources, and reports, analyze for unusual variances and potential rate errors and then upload into accounting software in order to generate detailed, accurate and timely customer billing invoices. Supports the Staff Accountant in answering customer questions on invoices. Support certain other accounting areas that are directly impacted by revenue, such as accounts receivable, sales tax payable, and collections. Analyze monthly third-party vendor invoices for usage payment accuracy. If errors are found, must be able to solve errors and notify appropriate contact. Qualifications of the Staff Accountant, Revenues Bachelor s degree (Business, Accounting or Finance preferred) 5 years accounting experience Knowledge, Skills, and Abilities of the Staff Accountant, Revenues Experience with Microsoft Office applications, and advanced skill with Microsoft Excel (pivot tables, Vlookups, etc.) Sage Intacct experience Salesforce experience Healthcare software experience Billing systems implementation experience a plus Must be able to think critically and complete analysis of data. Demonstrated ability to quickly learn and follow detailed processes and steps. Must be very organized and able to work effectively at a fast pace and stay focused despite distractions and/or interruptions. Self-motivated, strong work ethic, and reliable Ability to work flexible hours during peak times, good time-management skills. Solid listening, communication, and interpersonal skills with a strong customer service focus Excellent interpersonal and communication skills Excellent organizational skills and the ability to handle multiple, competing tasks simultaneously, work independently, and meet deadlines while maintaining a high standard of accuracy. Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Description: Key Responsibilities: 1. Accurate Payment Posting: - Accurately post all insurance and patient payments by line item using medical claim billing software. 2. Meeting Payment Posting Deadlines: - Meet deadlines for posting payments to ensure timely reconciliation of accounts receivable. 3. Interpretation of Explanation of Benefits (EOBs): - Read and interpret insurance EOBs to reconcile payments, denials, and adjustments for accurate posting. 4. Attendance at Staff Meetings and Educational Sessions: - Regularly attend monthly staff meetings and participate in continuing educational sessions to stay informed about industry updates and best practices. 5. Additional Duties as Requested: - Perform additional duties as requested by the supervisory or management team to support departmental objectives. 6.Training and solving queries: - To help the team with their queries and concern, help the team to reach their goals and required accuracy while posting. 7. HIPAA Compliance: - Follow HIPAA guidelines and maintain patient confidentiality when handling sensitive information during payment posting processes. 8. Data Security and Integrity: - Maintain the security and integrity of practice data being worked on to protect sensitive information and comply with regulatory requirements. 9. Revenue Cycle Performance Analysis: - Obtain a clear view of revenue cycle performance through accurate payment posting and data analysis. 10. Policies and Procedures Development: - Develop exhaustive policies and procedures for write-offs and adjustments to ensure consistency and compliance in financial transactions. Qualifications: - High school diploma or equivalent; associate or bachelor s degree in healthcare administration, Commerce/Arts or related field preferred. - Minimum of 1 to 2 years of experience in medical billing or revenue cycle management, with a focus on payment posting. - Strong attention to detail and accuracy in data entry and payment reconciliation. - Knowledge of medical billing software and electronic health record (EHR) systems. - Familiarity with insurance EOBs and payment reconciliation processes. - Understanding of HIPAA regulations and patient privacy requirements. - Excellent communication and interpersonal skills. - Ability to work independently and collaboratively in a fast-paced environment. - Commitment to meeting deadlines and achieving departmental goals

Job Description: Key Responsibilities: Automation Development: Design and develop RPA solutions using tools such as UiPath, Automation Anywhere, or Blue Prism. Automate repetitive and time-consuming tasks in workflows, including charge posting, claim processing, AR follow-ups, and denial management. Process Optimization: Analyze current workflows to identify automation opportunities. Collaborate with stakeholders to streamline processes and ensure alignment with business goals. Implementation and Deployment: Deploy RPA bots in the production environment and ensure seamless integration with existing systems. Conduct user acceptance testing (UAT) and address feedback to refine automation solutions. Maintenance and Support: Monitor the performance of deployed bots and troubleshoot issues. Perform periodic updates to bots to adapt to changes in workflows or systems. Documentation and Training: Create detailed documentation for automation processes, including process maps and technical guides. Train team members on utilizing RPA tools and bots effectively. Required Skills and Qualifications: Bachelor s degree in computer science, Information Technology, or related field. Requires a minimum of 5 years relevant experience in RPA development using tools like UiPath, Automation Anywhere, or Blue Prism. Preferably strong understanding of revenue cycle management processes, including billing, collections, AR, and denials. Proficiency in programming languages such as Python, .NET, or Java. Knowledge of database management (SQL) and APIs for system integration. Excellent analytical and problem-solving skills. Ability to work collaboratively with cross-functional teams and stakeholders. Strong communication skills, both verbal and written. Preferred Skills: Experience in the healthcare industry is highly desirable. Knowledge of Power BI or Tableau for creating reports and dashboards. Certification in RPA tools (e.g., UiPath Advanced Developer, Automation Anywhere Certified Advanced RPA Professional).

Essential Job Responsibilities Data Quality and Hygiene Clean and validate Salesforce data by removing duplicates, correcting errors, and ensuring completeness. Enforce data entry standards, including naming conventions and formatting rules. Monitoring and Auditing Conduct routine data integrity audits and monitor changes to detect unauthorized modifications. Manage duplicate identification and merging processes. Governance and Compliance Implement and enforce data governance policies . Ensure compliance with regulations like GDPR and CCPA. Collaboration and Training Work with sales, marketing, and customer success teams to address data issues. Train Salesforce users on best practices for data entry and maintenance. Automation and Tools Management Use tools like RingLead and Data Loader to streamline data cleaning. Create automated workflows and validation rules to improve data accuracy. Performance Tracking Track KPIs like data accuracy, duplicate rates, and completeness. Report recurring issues and recommend long-term solutions. Proactive Data Management Enhance data quality with third-party enrichment and lifecycle updates. Ensure alignment of account and lead data with territory structures. Testing and Quality Assurance Test data workflows, integrations, and system updates for accuracy. Validate data exchange between Salesforce and other systems. Knowledge, Skills, and Abilities Strong knowledge of CRM systems, particularly Salesforce, with the ability to integrate external data for seamless reporting and analysis. Exceptional analytical skills with the ability to interpret complex data sets and provide strategic recommendations. Ability to manage multiple tasks simultaneously, driving them to successful completion with minimal oversight. Excellent communication skills, with the ability to clearly articulate complex concepts to both technical and non-technical audiences. High degree of precision and attention to detail in all work. Ability to work autonomously in a fast-paced environment, adapting to changing priorities and deadlines.

Knowledge/Application Developing Knowledge: Seeks less guidance; comfortable analyzing facts and making decisions but keeps supervisor informed and involved as appropriate; Adherence to Ticket Productivity goals and SLA/SLO requirements; Resolve moderate to high complexity/priority requests with consistent quality. Clearly understands customer business needs and formulates accurate resolutions in addressing the customer need and proactively assists teammates with request resolutions. Developing knowledge in other domain areas. Working within additional service offerings (ESS) and participating in NRR-based projects (LOE/SOW). Breakdown of tasks per type (nomenclature dependent on ticketing solution): Low complexity/priority tasks: 25% Moderate/High complexity/priority tasks: 75% Seeks less guidance; Resolve moderate to high complexity/priority requests with consistent quality Duties/Responsibilities: Provide technical support to Customers by researching and answering questions; troubleshooting problems; and optimizing software performance through Cases, Live Chat, and Phone Support. Provide outstanding customer Service, including timely, concise, and accurate responses, and proactive Customer Issue management, while handling all Customer requests in a professional, positive, and dignified manner. Provide training and consultation Develop knowledge in other domain areas. Working within additional service offerings (ESS) and participating in NRR-based projects (LOE/SOW). Effectively communicates (Verbal, Listening, and Written) with team, leadership, and customers; Ability to ask probing questions based on effective listening. Creates a positive team environment with motivation and energy. Gains and maintains the trust and confidence of team members by demonstrating integrity, accountability and flexibility. Proactively assists teammates with request resolutions. On time and prepared for meetings. Make advanced arrangements when they are not available. Owns and delivers on commitments. Minimum Degree/Years of Experience Bachelors degree; High School diploma with relevant EHR/Software customer service or behavioral health agency experience may substitute for undergraduate degree 2 years of related experience Please Note Location: -Vadodara, Gujarat (Work from Office only) Shift: -US/Night Shift

Responsibilities: Investigate and resolve complex denial issues. Analyze denial trends to identify areas for process improvement. Initiate and lead payer calls for escalated denial inquiries, follow-up and disputes. Develop and implement strategies to reduce denial rates and improve reimbursement. Collaborate with internal stakeholders to address root causes of denials. Mentor Level 1 is associate with advanced AR/Denial management techniques. Prepare and submit appeals for denied claims as needed. Maintain comprehensive documentation of denial activities and outcomes. Requirements: Associate degree in healthcare administration or related field (preferred). Minimum of 2 years of experience in AR/Denial management or revenue cycle management. Proficiency in medical billing software and denial tracking systems. Strong problem-solving and analytical skills. Ability to effectively communicate with payers to negotiate claim resolutions. Leadership skills and ability to work independently. Attention to detail and accuracy in data analysis and reporting.

Key Responsibilities: Team Management Leadership: Supervise and mentor a team of rejection specialists, ensuring productivity and quality targets are met. Provide training on rejection trends, payer guidelines, and best practices for rejection resolution. Monitor team performance, conduct regular reviews, and implement process improvements. Collaborate with other RCM teams (Billing, AR, Denials) to optimize claim processing efficiency. Rejection Analysis Resolution: Oversee daily rejection reports and ensure rejections are addressed promptly to prevent claim denials. Identify recurring rejection patterns and work with the team to implement corrective actions. Guide the team in understanding payer-specific requirements and making necessary claim corrections. Escalate unresolved rejections to the appropriate team or payer for further resolution. Process Improvement Compliance: Analyze rejection trends and provide recommendations to improve clean claim submission rates. Develop and maintain standard operating procedures (SOPs) for handling different types of rejections. Ensure compliance with HIPAA regulations and payer policies. Work closely with billing, coding, and credentialing teams to minimize avoidable rejections. Reporting Communication: Prepare and present rejection analysis reports, including root cause analysis and resolution strategies. Communicate effectively with payers, providers, and internal stakeholders to resolve issues. Maintain accurate documentation of rejection trends, team performance, and corrective actions taken. Qualifications Requirements: Education: Bachelors degree preferred (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 . Industry Knowledge: Strong understanding of behavioral health billing , insurance guidelines, and payer policies. 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. Communication Skills: Excellent verbal and written communication for team coordination and payer interactions. Problem-Solving: Strong problem-solving skills to resolve complex claim rejections efficiently. 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.

Responsibilities: Investigate and resolve complex denial issues. Analyze denial trends to identify areas for process improvement. Initiate and lead payer calls for escalated denial inquiries, follow-up and disputes. Develop and implement strategies to reduce denial rates and improve reimbursement. Collaborate with internal stakeholders to address root causes of denials. Mentor Level 1 is associate with advanced AR/Denial management techniques. Prepare and submit appeals for denied claims as needed. Maintain comprehensive documentation of denial activities and outcomes. Requirements: Associate degree in healthcare administration or related field (preferred). Minimum of 2 years of experience in AR/Denial management or revenue cycle management. Proficiency in medical billing software and denial tracking systems. Strong problem-solving and analytical skills. Ability to effectively communicate with payers to negotiate claim resolutions. Leadership skills and ability to work independently. Attention to detail and accuracy in data analysis and reporting.

Responsibilities Take initiatives from the business (product managers), break them down into stories, and work with engineering to implement them. Create, maintain, and prioritize the product backlog with detailed user stories, acceptance criteria, and estimations. Collaborate with the development team to refine backlog items and ensure clarity on requirements. Provide coaching and general leadership to other product owners Provide supervision and administer various people manager processes including time and attendance management. Will be responsible, with support from direct manager, for ensuring teams goal setting, performance management and reviews, engagement initiatives, annual compensation reviews and other people leadership tasks are effectively completed. Actively participate in Scrum ceremonies (sprint planning, daily scrums, sprint review, sprint retrospective). Provide necessary information and answer questions to ensure development team understands product requirements. Collaborate with scrum master to optimize the teams process and remove impediments. Define acceptance criteria for each user story and ensure features are delivered to the desired quality standard. Collaborate withe the team to plan and execute product releases. Evaluate progress at each stage of development to ensure alignment between development teams and business stakeholders. Facilitate communication between the development team, key business stakeholders, and customers to gather feedback and manage expectations. Conduct user testing, sprint reviews, and betas to gather feedback and identify areas for product improvement. Address concerns and help resolve conflicts related to product features and priorities. Qualifications Higher Education (BS/BA equivalent) 5+ (+) years experience in product owner or directly related role with healthcare or B2B software industry experience Prior experience and success in leading teams, ideally with direct experience as a team lead or supervisor preferred but may consider those who have led others in a non-official capacity and demonstrate strong leadership attributes. Understanding of the Agile process and methodologies Expert communication skills with ability to drive conversations with senior business and technical staff/leadership Analytical thinker with the ability to understand business needs to make informed product decisions Has developing commercial mindset and experience evaluating priorities based on financial and commercial impact Demonstrated ability to balance empathy and accountability when leading others Knowledge in specialty focus area relevant to specific product focus of role is highly desired Computer Sciences, Data / Analytics, Healthcare Regulatory , Healthcare RCMS, Clinical Knowledge Preferences Strong preference for knowledge of the US healthcare industry, ideally behavioral health and prior EHR experience very helpful Prior experience within the Credible EHR