Rcm Specialist_DME/HME

Job Description

Lets 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:

• Minimum 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