RCM Specialist

Brightree is a wholly owned subsidiary of ResMed (NYSE: RMD, ASX: RMD).

When you work at Brightree, it’s more than just a job. You’ll be part of a team that’s driving innovation and leading the way in cloud-based patient management software.

The technology allows us to provide the tools for better outcomes but at our heart, we’re really about people. We strive to positively impact our customers’ businesses and the lives of patients every single day.

This position reports to the RCM Adjustment and Refund Team Lead and is responsible for the quality and achievement of revenue adjustment goals. We are looking for someone who is highly motivated,

passionate about customer service, with the ability to follow policies and procedures as directed by Medicare, Medicaid and private insurances. Our Quality Review Specialist will work together with

internal and external customers on the phone, via software applications and via email. If you are seeking a rewarding position in the rapidly expanding healthcare and technology solutions space our Quality

Review Specialist position in the RCM Adjustments Department is for you!

Key accountabilities and decision ownership:

• Performs quality review and edits to assure adjustments, rebills and refunds are completed accurately and according to the procedures established
• Makes procedure recommendations and updates procedure documents for optimal performance
• Communicates and works with cross-functional departments to identify potential risks and solutions for performance improvement
• Identifies potential deficiencies in processes via analysis and trends
• Provides education and assists in implementation of procedure changes
• Identifies training needs and reports to Team Lead
• Assures SLA’s and quality of work thresholds are maintained
• Drives change through collaboration, influence, and partnerships
• Manages workload to complete assignments in a timely fashion
  
  
  

Skills, experience, technical/professional qualifications: Must have:

• High school education required, Associate’s or Bachelor’s Degree a plus
• Two years' DME Accounts Receivable Experience
• Effective communication skills with strong oral, written and persuasive abilities to work with people at all levels in the organization, as well as for documenting notes in client systems
• Exceptional organizational skills with a high-level of attention to detail and the ability to multitask within multiple client databases
• Demonstrated ability to work independently and complete tasks in a timely manner
• Strong computer proficiency with Microsoft Office and Databases Preferred:
• Passionate about customer service
• Excellent problem-solving skills focused on identifying and implementing solutions for internal and external customers
• Strong ethics with a high-level of personal and professional integrity
• Results driven self-starter who is highly motivated and able to troubleshoot challenges on the fly
• Proven track record of working towards and exceeding metrics
  
  
  

Highly Preferred:

• Brightree Software Experience
  
  
  

We are shaping the future at ResMed, and we recognize the need to build on and broaden our existing skills and continue to attract and retain the world’s best talent. We work hard to offer holistic benefits packages, provide flexible work arrangements, cultivate a workforce culture that allows employees to grow personally and professionally, and deliver competitive salaries to our team members. Employees scheduled to work 30 or more hours per week are eligible for benefits. This position qualifies for the following benefits package: comprehensive medical, vision, dental, and life, AD&D, short-term and long-term disability insurance, sleep care management, Health Savings Account (HSA), Flexible Spending Account (FSA), commuter benefits, 401(k), Employee Stock Purchase Plan (ESPP), Employee Assistance Program (EAP), and tuition assistance. Employees accrue fifteen days Paid Time Off (PTO) in their first year of employment, receive 11 paid holidays plus 3 floating days and are eligible for 14 weeks of primary caregiver or two weeks of secondary caregiver leave when welcoming new family members.

Individual pay decisions are based on a variety of factors, such as the candidate’s geographic work location, relevant qualifications, work experience, and skills.

At ResMed, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current base range for this position is: $16.00 - 20.00 - 24.00 USD Hourly

For remote positions located outside of the US, pay will be determined based the candidate’s geographic work location, relevant qualifications, work experience, and skills.

Joining us is more than saying “yes” to making the world a healthier place. It’s discovering a career that’s challenging, supportive and inspiring. Where a culture driven by excellence helps you not only meet your goals, but also create new ones. We focus on creating a diverse and inclusive culture, encouraging individual expression in the workplace and thrive on the innovative ideas this generates. If this sounds like the workplace for you, apply now! We commit to respond to every applicant.