Revenue Cycle Representative - Auth & Eligibility

ResMed has always applied the best of technology to improve people's lives. Now our SaaS technology is fueling a new era in the healthcare industry, with dynamic systems that change the way people receive care in settings outside of the hospital–and tools that work every day to help people stay well, longer. We have one of the largest actionable datasets in the industry, creating a complete view of people as they move between care settings. This is how we empower providers–with vital insight to deliver the care people need, right when they need it.

We're also ensuring that our health solutions connect to other companies' networks. Because when objectives align, everyone wins. And as we work today to drive better care and lower costs, we're developing more personalized solutions for tomorrow, utilizing machine learning, intelligent care paths, and predictive protocols. If you are an innovator who wants to make an impact we want to talk to you! We have exciting opportunities supporting Brightree by ResMed and MatrixCare by ResMed!

Revenue Cycle Representative - Auth & Eligibility

We are a dynamic Revenue Cycle Management (RCM) and software company committed to delivering exceptional billing services and innovative solutions to our clients. We are seeking a high-caliber individual who is passionate about healthcare billing and eager to grow within a fast-paced, collaborative environment.

Position Summary

The Revenue Cycle Representative is responsible for providing accurate and timely billing services to both software and non-software clients. This role plays a key part in maintaining client satisfaction and ensuring the financial health of our customers through effective claims management and reimbursement follow-up.

Responsibilities:

• Monitor and follow up on Eligibility & Authorization requirements for assigned agencies’ census.

• Submit claims timely to Medicare, Medicaid and Private Payers for software clients and non-software clients.

• Ensures that the claims processed correctly and were accepted by the payer.

• Process adjustments and re-file claims as needed.

• Member of a cohesive team that works to maintain the AR for HEALTHCAREfirst customers

• Troubleshoot reimbursement issues and claim follow-up

• Works at the established Productivity level

• Builds relationships with clients regarding their billing needs and assist with claim resolutions as needed.

• Addresses client concerns in a timely manner

• Escalates unresolved customer grievances to the proper department, or management for further assessment.

• Understanding of Medicare rules, regulations, billing codes

• Maintain confidentiality and knowledge of HIPAA regulations

• Performs other duties as assigned

Qualifications:

• Minimum 1-3 years of progressive Home Health and/or Hospice billing experience preferred.

• Prior experience working with Medicare rules, regulations, billing codes (preferred)

• Education equivalent to a High school diploma, college degree preferred

• Ability to perform basic bookkeeping and compile statistics as needed

• Ability to work independently

• Must be organized and able to multitask

• Strong written and verbal communication skills

• Ability to type, operate computers and office equipment

• Aptitude for learning computer systems

• Ability to perform basic bookkeeping and compile statistics as needed

• Maintain a professional demeanor, courteous and flexible at all times

• Open to dynamic change and ability to thrive in such an environment

• Willingness and ability to work effectively with members of other departments

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.