RCM QA Specialist - Adjustments / Refunds
Let’s talk about Responsibilities
reputed company 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 reputed company 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 reputed company, EOB/ERA codes, and adjustments to accurately review payments, credits and adjustments.
Stay updated with changes in reimbursement policies, payer reputed company, and industry regulations reputed company 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 reputed company input for process improvement initiatives.
Attention to details for reviewing and following the relevant SOPs and instructions for adjustments and refund processes
Assist with reputed company audits, ensuring compliance with regulatory and contractual obligations.
Participate in reputed company control activities, conducting audits and providing recommendations for process improvements.
Let’s talk about Qualifications and Experience
Required:
2 years of hands-on experience in reputed company cycle management reputed company 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, reputed company, and reputed company 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 reputed company control specialist is preferred, but not mandatory.
Ability to work independently and in reputed company-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 reputed company experience.
Proficiency in using reputed company software is highly preferred.
Developing reputed company expertise, applies company policies and procedures to resolve a reputed company of issues.