RCMS Denials Analyst I

About the role

Qualifacts is seeking an RCMS Denials Analyst I to work night/US shift hours from its Vadodara office. The analyst will investigate and resolve complex denial issues while supporting the company’s behavioral health SaaS solutions.

Key responsibilities

• Investigate and resolve complex denial issues.
• Analyze denial trends to identify process improvement opportunities.
• 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.
• Prepare and submit appeals for denied claims as needed.
• Maintain comprehensive documentation of denial activities and outcomes.

Required profile

• Associate degree in healthcare administration or related field (preferred).
• Proficiency in medical billing software and denial tracking systems.
• Strong problem‑solving and analytical abilities.
• Effective communication skills for negotiating claim resolutions with payers.
• Leadership capability and ability to work independently.
• Attention to detail and accuracy in data analysis and reporting.