




**Job Description:** In this role, you will not merely be an executor but a technical mediator and a focal point for problem resolution. You will conduct critical analysis of non-payment, engage in complex negotiations with Health Insurance Providers, and provide direct support to management for process improvements impacting the revenue cycle. If you possess sharp analytical insight, mastery of billing tables, and the ability to guide new employees, we want to meet you. Key Responsibilities **Strategic Management of Claim Denials and Non-Payment:** Manage the portfolio of claim denial appeals, assign targets, and monitor reviewers’ performance. Conduct critical analysis of claim denials and non-payment returns, preparing well-substantiated rebuttals to recover revenue. Monitor high-value denials ("total denials") and proactively resolve them. • Reconcile balances (denials vs. work performed) to ensure accuracy of credit write-offs. **Process Improvement and Mediation:** Serve as a technical mediator in resolving routine team issues. • Identify the "root cause" of denials and drive corrective actions regarding system configuration with production departments and health insurance providers. Flag procedural failures to management and propose corrective actions to support decision-making. **Team Development:** Conduct introductory training for new employees and ensure understanding of Standard Operating Procedures (SOPs). Operationally oversee team deliverables, ensuring technical quality. • Align with coordination leadership, preparing for future succession and leadership challenges. **Requirements:** **Education:** Bachelor’s degree completed or in progress in Administration, Finance, or related fields. **Experience:** Relevant experience (billing, claim denials, medical billing). **Tools:** Proficiency in Microsoft Office Suite (Advanced/Intermediate Excel for data analysis).


