You could say Brightree by ResMed is a technology company. And that’s true. But Brightree is, at its heart, about people. We develop innovative, end-to-end technology solutions and services for people facing everyday challenges in the post-acute care industry. Brightree helps streamline processes, improve efficiency, and increase profitability. For over fifteen years, organizations big and small have put their trust in us—for our wide-ranging solutions, our leadership, and our unmatched customer service. Going to work each day and creating new ways to positively impact our customers’ businesses and the lives of patients is just what we do. Because Brightree is, after all, about people. To learn more about Brightree technology and solutions watch this short video by our CEO: https://www.brightree.com/whychoosebrightree A Brightree Quality Assurance Specialist is the front line in assuring the success of the entire Billing Center. Our QA Specialists are responsible for trending analysis, implementation, and education for our partners and clients. Let’s talk about Responsibilities Required to learn multiple insurance guidelines and specific durable medical equipment requirements for Medicare, National Commercial and Medicaid plans, including HMO replacement plans. ·Responsible for ensuring quality confirmation for optimal claim processing Immediate escalation of quality related issues Required to analyze medical documentation to qualify the patient for the equipment, supplies, or testing being ordered by provider specification Conducts random audit on all transactions processed by our internal teams and communicate and track trended results Required to escalate quality related issues, errors, trainings, and support to our Internal & External Teams in a timely manner Regularly creates & modifies Standard Operating Procedures (SOP) & Workflow system for specific payor and/or client rules Implements and adhere to policies, procedures, and systems within the Brightree systems Ensures accuracy to optimize reimbursement while adhering to company policies while maintaining compliance. Ensures adherence to objectives, operating policies and procedures, and strategic action plans for achieving goals to improve Revenue Cycle practices and increase revenue Must be detail oriented and complete tasks in a timely manner Other tasks and responsibilities as assigned Let’s talk about Qualifications and Experience High School degree required; college coursework a plus Knowledge of durable medical equipment and insurance billing Strong communication skills, ability to multi-task and conduct multiple levels of service to clients from basic to in depth while maintaining task completion and timely deadlines Capable user of Microsoft Office products including: Outlook, Excel, Word and PowerPoint Capable user of remote collaboration tools: Zoom, Go-To Meeting, Microsoft Teams and Sharepoint Knowledge of Power Mobility, Sleep Studies, and CGMs. Brightree software knowledge #LI-RH1 #LI-Remote 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 range for this position is: $16.30 - $24.44/hr 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! At ResMed (NYSE: RMD, ASX: RMD) we pioneer innovative solutions that treat and keep people out of the hospital, empowering them to live healthier, higher-quality lives. Our digital health technologies and cloud-connected medical devices transform care for people with sleep apnea, COPD and other chronic diseases. Our comprehensive out-of-hospital software platforms support the professionals and caregivers who help people stay healthy in the home or care setting of their choice. By enabling better care, we improve quality of life, reduce the impact of chronic disease and lower costs for consumers and healthcare systems in more than 140 countries. To learn more, visit ResMed.com and follow @ResMed. ResMed Corporation is an equal opportunity employer and provides equal opportunity in employment for all qualified persons, without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law. (US/Canada only) ResMed is an equal opportunity/affirmative action employer. ResMed is an E-Verify Employer. ResMed is a smoke-free workplace. We are a 2023 Circle Back Initiative Employer – we commit to respond to every applicant!