RCMS AR Specialist I

About the role

The RCMS AR Specialist I will focus on investigating and resolving complex claim denials within the healthcare revenue cycle. You will work closely with payers and internal teams to reduce denial rates, improve reimbursement, and ensure accurate documentation of all activities.

Key responsibilities

• Investigate and resolve complex denial issues.
• Analyze denial trends to identify process improvement opportunities.
• 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 associates on advanced AR/Denial management techniques.
• 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 a related field (preferred).
• 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.

Required skills

• Proficiency with medical billing software.
• Experience using denial tracking systems.