Key skills
Communication
About this role
Role Overview
- 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
Requirements
- 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
- Bachelor's degree preferred, with 2 years of related experience
- Proficiency in using Brightree software is highly preferred.
Benefits
- Professional development opportunities
- Health insurance