ResMed is a medical company that is striving to better treat and keep patients out of the hospital by developing innovative devices and software solutions. As an employer, the comp
RCM Specialist - Quality
Location
India
Posted
6 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
RCM Specialist - Quality
ResMed
Role 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. Qualifications - 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. - 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. Requirements - Bachelor’s degree (preferred). - 2 years of related experience (preferred). - Proficiency in using Brightree software is highly preferred. - Developing professional expertise, applies company policies and procedures to resolve a variety of issues. Benefits - Joining us is more than saying “yes” to making the world a healthier place. - Discover a career that’s challenging, supportive, and inspiring. - A culture driven by excellence helps you not only meet your goals but also create new ones. - Focus on creating a diverse and inclusive culture, encouraging individual expression in the workplace. - Thrive on the innovative ideas generated by a diverse workforce. Company Description We commit to respond to every applicant.
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