RCM QA Specialist – Adjustments, Refunds

This is a fully remote position, open to applicants in India.

📋 Description

• Strong understanding of accounts receivable follow-up and denial management.

• Timely and precise processing of adjustments and refunds.

• Perform comprehensive reviews of adjustments and refunds.

• Analyze accounts to resolve discrepancies related to adjustments and refunds.

• Maintain a thorough knowledge of US payer contracts and EOB/ERA codes.

• Keep abreast of changes in reimbursement policies and payer agreements.

• Document adjustments and refund processes meticulously.

• Engage in team meetings and contribute to process enhancement initiatives.

• Support both internal and external audit processes.

• Take part in quality control efforts.

⛳️ Requirements

• Minimum of 2 years of practical experience in revenue cycle management within the DME/HME field.

• Strong expertise in AR follow-up and denial management procedures.

• Comprehensive knowledge of US payer management, including Medicare, Medicaid, and commercial insurance.

• Excellent verbal and written communication abilities.

• Detail-oriented with outstanding analytical and problem-solving capabilities.

• Prior experience as an auditor and quality control specialist is advantageous.

• Capacity to work autonomously as well as collaboratively in a team setting.

• Strong organizational skills with the ability to prioritize tasks effectively and meet deadlines.

• Current knowledge of coding and billing regulations, reimbursement guidelines, and industry trends.

• Bachelor's degree is preferred.

🏝️ Benefits

• Health insurance.

• Retirement plans.

• Paid time off.

• Flexible work arrangements.

• Opportunities for professional development.