Job Description

Qualifacts Systems, Inc. is looking for RCMS AR Specialist II to join our dynamic team and embark on a rewarding career journey Billing & Invoicing: Generate and review accurate invoices through the RCMS platform for self-pay and third-party payers. Validate charge capture data from clinical and services departments prior to billing. Payment Posting & Reconciliation: Post payments, adjustments, and write-offs in RCMS and general ledger systems. Reconcile daily cash buckets and investigate discrepancies between bank deposits and system postings. Denial & AR Follow-Up: Monitor aging reports and aging buckets in RCMS; prioritize and manage escalation of past-due accounts. Research claim denials and rejections; prepare and submit appeals or corrected claims to payers. Patient & Payer Inquiry Resolution: Act as primary point of contact for patient billing inquiriesexplain statements, provide payoff quotes, arrange payment plans. Interface with insurance carriers to resolve coverage, eligibility, and claims-status questions. Reporting & Analysis: Produce weekly/monthly AR performance reports (days in AR, net collection rate, denial %, etc.). Analyze trends to recommend process improvements and reduce avoidable denials or write-offs.