ResMed is seeking a Remote RCM QA Specialist focused on adjustments and refunds within the revenue cycle management sector. The ideal candidate will have at least two years of experience in AR follow-up, denial management, and a strong understanding of US payer contracts, ensuring timely and accurate processing of financial adjustments
Job Summary
Conduct thorough adjustments & refund reviews, ensuring accuracy and adherence to established procedures.
Maintain a comprehensive understanding of US payer contracts, EOB/ERA codes, and adjustments to accurately review payments, credits and adjustments.
Participate in quality control activities, conducting audits and providing recommendations for process improvements.
Matching Summary
Match Score: 85
ResMed is seeking a Remote RCM QA Specialist focused on adjustments and refunds within the revenue cycle management sector. The ideal candidate will have at least two years of experience in AR follow-up, denial management, and a strong understanding of US payer contracts, ensuring timely and accurate processing of financial adjustments.
Skills & Requirements
Must-have
AR follow-up and denial management
US payer contracts and EOB/ERA codes
Reimbursement policies and regulations
Documentation of processes and guidelines
Nice-to-have
Process improvement initiatives
Team meetings and collaboration
Independent and team-oriented work
Key Requirements
2 years RCM experience in DME/HME
Strong AR follow-up and denial management
In-depth US payer knowledge
Excellent communication and analytical skills
Detail-oriented
Up-to-date coding and billing regulations knowledge