Rcm Qa Specialist - Adjustments / Refunds

IR Jobs

Not specified (assumed hybrid based on industry norms).
2 years revenue cycle management experience
Dme/hme specialty knowledge
Us payer contract understanding
The job posting seeks a Revenue Cycle Management (RCM) QA Specialist focusing on adjustments and refunds at IR Jobs, requiring expertise in accounts receivable follow-up and denial management. The ideal candidate should possess strong analytical skills, a comprehensive understanding of US payer contracts, and be detail-oriented

Job Summary

  • The role requires a strong understanding of AR follow-up and denial management to resolve outstanding issues and minimize AR aging.
  • Candidates must maintain comprehensive knowledge of US payer contracts, EOB/ERA codes, and reimbursement policies specific to insurance write-offs.
  • The position involves conducting thorough reviews of adjustments and refunds while ensuring compliance with regulatory and contractual obligations.

Matching Summary

Match Score: 80

The job posting seeks a Revenue Cycle Management (RCM) QA Specialist focusing on adjustments and refunds at IR Jobs, requiring expertise in accounts receivable follow-up and denial management. The ideal candidate should possess strong analytical skills, a comprehensive understanding of US payer contracts, and be detail-oriented.

Skills & Requirements

Must-have

  • 2 years revenue cycle management experience
  • DME/HME specialty knowledge
  • US payer contract understanding
  • AR follow-up and denial management
  • Adjustments and refund processing accuracy

Nice-to-have

  • Previous auditor or quality control experience
  • Brightree software proficiency
  • Bachelor's degree preferred
  • Process improvement initiative participation
  • Strong analytical problem-solving skills

Key Requirements

  • 2 years hands-on experience in revenue cycle management
  • Experience within DME/HME specialty
  • In-depth understanding of Medicare, Medicaid, and commercial insurance
  • Proficiency in Brightree software (preferred)
  • Bachelor's degree (preferred)

Work Rights

Not specified

Tailored Resume

Cover Letter