Payor Analyst DME (Remote)

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.

As a Payor Analyst, you'll be at the forefront of ensuring compliance with Medicare, Medicaid, and private insurance policies. Your responsibilities include managing financial outcomes for insurance companies and Brightree customers, crafting and enhancing standard operating procedures, educating partners, vendors, and internal teams, and conducting quality assurance on team performance. You'll bring a wealth of expertise with a minimum of 2 years of direct experience in accounts receivables, and you'll be our financial expert, overseeing precision and accuracy with professionalism and proficiency.

Key Responsibilities and Decision Ownership:

• Mastering general rules and methods to optimize reimbursement from assigned insurance companies.

• Resolving and directing incoming Salesforce cases from customers.

• Ensuring financial accuracy by minimizing credit adjustments, write-offs, and optimizing billing methodologies.

• Proposing updates to Brightree system configurations, including price tables and insurance settings.

Identifying opportunities to streamline processes and continuously improving business and system procedures.

• Preparing and submitting reports on quality assurance, denial analysis, and service level agreements.

• Ensuring adherence to objectives, policies, and procedures while collaborating with global resources for effective issue resolution.

• Maintaining patient confidentiality within HIPAA guidelines.

Required Skills and Qualifications:

Must Have:

• High school diploma; equivalent education and experience considered.

• Minimum of 2 years of accounts receivable experience.

• Minimum of 2 years of experience in maintaining HIPAA standards.

• Proficiency in computers and Microsoft products (Excel and Word).

• Strong motivation in billing, claims, denials, and document management.

• Exceptional organizational and problem-solving skills.

• Effective communication abilities at all organizational levels.

• Proven track record of exceeding metrics.

Preferred:

• 2-year degree or additional college coursework.
• 5 years of experience in a healthcare reimbursement role.
• Experience In DME
• 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: 15.36 - 19.20 - 23.04 USD Hourly

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.