Pioneering innovative medical device and digital health solutions that treat and keep people out of the hospital.
RCM QA Specialist - Adjustments / Refunds
Location
India
Posted
2 days ago
Salary
0
Seniority
Mid Level
Job Description
RCM QA Specialist - Adjustments / Refunds
ResMed
Role Description - Very good understanding of AR follow-up and denial management, to resolve outstanding issues and minimize AR aging processing appropriate write offs and adjustments. - Accurately and timely adjustments and refund processing, into the billing system. - Conduct thorough adjustments & refund reviews, ensuring accuracy and adherence to established procedures. - Review accounts and resolve discrepancies in adjustments & refunds to ensure accurate financial records. - Maintain a comprehensive understanding of US payer contracts, EOB/ERA codes, and adjustments to accurately review payments, credits and adjustments. - Stay updated with changes in reimbursement policies, payer contracts, and industry regulations related to insurance write offs, adjustments and refund specific rules. - Maintain documentation of adjustments and refund processes, procedures, and payer-specific guidelines. - Participate in team meetings and provide input for process improvement initiatives. - Attention to details for reviewing and following the relevant SOPs and instructions for adjustments and refund processes. - 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 - Required: 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. - Preferred: Bachelor’s degree. - 2 years of related experience. - Proficiency in using Brightree software is highly preferred. Benefits - Joining us is more than saying “yes” to making the world a healthier place. - It’s discovering a career that’s challenging, supportive and inspiring. - Where a culture driven by excellence helps you not only meet your goals, but also create new ones. - We focus on creating a diverse and inclusive culture, encouraging individual expression in the workplace and thrive on the innovative ideas this generates. - If this sounds like the workplace for you, apply now! - We commit to respond to every applicant.
Related Guides
Related Categories
Related Job Pages
More QA Engineer Jobs
Team Lead – Senior Technical QA, Architecture, BIM, Construction Delivery
OLIANTUnleash the Power of Quality.
• Lead a team of junior technical QA associates and delivery specialists. • Own the quality, accuracy, and timeliness of the team’s deliverables. • Review work before it reaches the client or senior stakeholders. • Ensure data accuracy, reporting consistency, and adherence to project standards. • Help team members interpret construction drawings, 3D models, markups, RFIs, redlines, comments, and other technical documents. • Support weekly workload planning and help assign team members based on project needs, skill level, and capacity. • Maintain internal trackers, project status updates, and delivery documentation. • Provide structured feedback to team members. • Train junior team members on workflows, drawing interpretation, QA standards, platform usage, and delivery expectations. • Identify recurring issues and recommend process improvements. • Escalate blockers, risks, and quality concerns early. • Coordinate with other remote teams involved in project setup, configuration, mapping, QA, and delivery. • Participate in client-facing or internal stakeholder meetings when needed. • Help create a culture of ownership, quality, accountability, and continuous improvement.
• Automated test coverage: Design and grow our E2E and integration test suite using Cypress. Set the strategy, prioritize coverage gaps, and raise the floor across the platform. • Bug process: Own the full lifecycle from triage to production fix. Keep it moving, keep stakeholders informed, and make sure nothing falls through the cracks. • Cross-functional quality partnership: Collaborate with PMs, Designers, and the Data team to review requirements, raise risks early, and define what "done" actually means. • Process improvement: Identify weaknesses in how we deliver software and propose solutions. • Exploratory testing: Test new features and existing flows on web and mobile across devices, catching what automation misses.
Role Description Buscamos um Analista de Testes Automatizados JR/PL para atuar de forma remota em cliente da Lighthouse. - Executar testes funcionais; - Projetar e desenvolver planos e cenários de testes; - Elaborar e manter cenários e casos de teste bem estruturados (documentação); - Garantir a qualidade de sistemas e aplicações através da definição e execução de estratégias de testes; - Planejar, criar e manter casos de teste para regras de negócio; - Executar testes funcionais, de regressão, exploratórios e automatizados; - Identificar, registrar e acompanhar defeitos, propondo melhorias nos processos de QA. Qualifications - Experiência prática com testes automatizados e outras ferramentas (Selenium, Cypress, Playwright, Jenkins ou similares); - Experiência na criação de cenários de testes; - Experiência na execução de testes funcionais; - Conhecimento dos principais tipos de testes (funcionais, regressão, desempenho, etc); - Conhecimento das metodologias de testes; - Conhecimento de métricas de qualidade; - Capacidade de elaborar e manter cenários e casos de teste bem estruturados (escrever documentação); - Conhecimento em Postman para testes de APIs REST será considerado um diferencial; - Experiência com e-commerce será um diferencial. Requirements - Boa comunicação; - Proatividade; - Visão crítica; - Habilidade de trabalhar em equipe multidisciplinar.
• Perform functional and regression testing for WordPress and WooCommerce applications. • Validate emergency-profile workflows and end-user experiences. • Verify application behavior following security, PHP, architecture, and infrastructure changes. • Test role-based access control (RBAC) permissions and access scenarios. • Validate QR-based access and profile retrieval workflows. • Design, execute, and maintain comprehensive test cases. • Identify, document, prioritize, and track defects through resolution. • Collaborate closely with developers and project stakeholders to ensure product quality. • Support validation efforts associated with platform modernization, security improvements, and compliance initiatives.



