RCM Specialist - Quality

IndiaRemote

Responsibilities

Conduct thorough AR follow-up and denial management, working closely with the billing teams to resolve outstanding issues and minimize AR aging.
Collaborate with internal teams, including billing, coding, and compliance, to ensure accurate and compliant claim submissions.

experience in revenue cycle management within the DME/HME specialty. Strong knowledge and
experience with AR follow-up and denial management processes.
Excellent written and verbal communication skills, with the ability to effectively communicate with internal teams, clients, and payers.
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.

Maintain a comprehensive understanding of US payer policies, rules, and regulations, with a particular focus on Medicare, Medicaid, and other relevant insurance plans.
In-depth understanding of US payer management, including Medicare, Medicaid, and commercial insurance.

Responsibilities Manage and oversee the revenue cycle process for DME/HME services, ensuring timely and accurate billing, claims submission, and payment posting.
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. Let’s talk about Qualifications and