Job Description
- Manage and oversee the revenue cycle process for DME/HME services, ensuring timely and accurate billing, claims submission, and payment posting.
- Conduct thorough AR follow-up and denial management, working closely with the billing teams to resolve outstanding issues and minimize AR aging.
- Maintain a comprehensive understanding of US payer policies, rules, and regulations, with a particular focus on Medicare, Medicaid, and other relevant insurance plans.
- Collaborate with internal teams, including billing, coding, and compliance, to ensure accurate and compliant claim submissions.
- Stay up-to-date with industry changes, including coding and billing requirements, reimbursement guidelines, and regulatory updates.
- Assist with internal and external audits, ensuring compliance with regulatory and contractual obligations.
- Participate in quality control activities, conducting audits and providing recommendations for process improvements.
Required:
- Minimum 2 years of hands-on experience in Revenue Cycle Management within the DME/HME specialty.
- Strong knowledge and experience with AR follow-up and denial management processes.
- In-depth understanding of US payer management, including Medicare, Medicaid, and commercial insurance.
- Excellent written and verbal communication skills, with the ability to effectively communicate with internal teams, clients, and payers.
- Detail-oriented with exceptional analytical and problem-solving skills.
- Previous experience as an auditor and quality control specialist is preferred, but not mandatory.
- Ability to work independently and in a team-oriented environment.
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- Strong organizational skills with the ability to prioritize tasks and meet deadlines.
- Up-to-date knowledge of coding and billing regulations, reimbursement guidelines, and industry trends.
- Bachelors degree.
- 2 years of related experience.
- Proficiency in using Brightree software is highly preferred.
- Developing professional expertise, applies company policies and procedures to resolve a variety of issues.
Skills
InsuranceIf an employer asks you to pay any kind of fee, please notify us immediately. Jobaaj does not charge any fee from the applicants and we do not allow other companies also to do so.
About Company
ResMed is a global leader in digital health, specializing in innovative solutions for sleep apnea, chronic obstructive pulmonary disease (COPD), and other respiratory conditions. With a commitment to improving the quality of life for millions, ResMed develops cutting-edge medical devices and cloud-based software to diagnose, treat, and manage respiratory disorders effectively. ResMed careers offer exciting opportunities for professionals to contribute to groundbreaking healthcare technologies. Join ResMed to be part of a dynamic team that values innovation, collaboration, and making a difference in patients' lives. Explore rewarding ResMed careers and embark on a fulfilling journey in digital health innovation.
Important dates & deadlines?
Application Deadline
15 Aug 26, 03:38 PM IST
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RCM Specialist - Quality (US Healthcare - DME/HME)
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