RCM Administrator - Resubmission

Key Responsibilities: Identify, appeal, and reverse claims that are denied or underpaid inappropriately by payors. Collaborate with departments such as Health Information Management (HIM), coding, and medical teams to gather necessary documentation for appeals. Work proactively with multidisciplinary teams to create procedures that minimize denials through trend reporting and education. Assist management with payor contract interpretation and ensure communication is updated for hospital staff. Analyze and report data related to underpayments, denials, and revenue opportunities. Categorize denials by root cause and share findings with management. Act as a resource for billing and reimbursement issues as needed. Stay informed about relevant regulations and maintain current knowledge in the field. Execute special audit requests for denials and support the drafting of appeal letters. Ensure smooth insurance operations through collaboration with colleagues. Maintain strict confidentiality of medical records and data. Provide support in medical coding and billing as necessary. Perform additional duties as requested by management.

Desired Candidate Profile

Qualifications: Bachelor s degree in Para Medical, Accounting, or a related field. Minimum of 3 years of experience, including 2 years in denial analysis and resubmission within a hospital or Day Surgical Centre setting. Coding Certification from AHIMA or AAPC. Experience with managed care contracts and reconciling patient accounts is highly desirable. Proficient in written and spoken English. If you are a dedicated professional committed to quality and efficiency, we encourage you to apply. The submission deadline is Sunday, 4-May-2025. Only selected candidates will be contacted.