RCM - Quality Analyst

2 weeks ago

India ResMed Full time

You could say Brightree by ResMed is a technology company. And that's true. But Brightree is, at its heart, about people. We develop innovative, end-to-end technology solutions and services for people facing everyday challenges in the post-acute care industry. Brightree helps streamline processes, improve efficiency, and increase profitability. For over fifteen years, organizations big and small have put their trust in us—for our wide-ranging solutions, our leadership, and our unmatched customer service. Going to work each day and creating new ways to positively impact our customers' businesses and the lives of patients is just what we do. Because Brightree is, after all, about people.

To learn more about Brightree technology and solutions watch this short video by our CEO:

Quality Analyst – RCM India

Let's talk about Responsibilities

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.

Let's talk about Qualifications and Experience
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. Developing professional expertise, applies company policies and procedures to resolve a variety of issues.

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.

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