AR RCM Specialist - DME

ResMed

About The Position

Brightree by ResMed is hiring an AR RCM Specialist to manage revenue cycle performance for assigned clients, payors, and states. The role serves as a primary operational contact for clients and supports reimbursement optimization, denial prevention, accounts receivable management, revenue recovery, and operational excellence. It works with clients, global operations teams, leadership, and cross-functional partners to resolve challenges, identify improvement opportunities, and deliver measurable financial and customer outcomes. The position involves analyzing payor and client data, monitoring operational performance and service levels, developing process documentation, educating teams on reimbursement requirements, and recommending improvements to workflows, payer setup, and pricing. It also includes preparing reports and analyses, monitoring compliance, and taking ownership of action plans through resolution. The role is part of a team focused on helping healthcare providers operate efficiently and deliver patient care.

Requirements

High school diploma.
At least 2 years of DME/HME Revenue Cycle Management experience.
Experience managing accounts receivable, denials, appeals, and reimbursement resolution activities.
Strong knowledge of Medicare, Medicaid, and Commercial payer billing and reimbursement requirements.
Experience conducting trend analysis and root cause investigations and identifying revenue cycle improvement opportunities.
Ability to present findings, recommendations, and performance insights to clients and leadership.
Strong analytical and problem-solving skills, including the ability to translate data into action.
Excellent written, verbal, and presentation communication skills.
Strong organizational skills, attention to detail, and ability to manage multiple priorities.
Ability to work independently and drive issues through resolution.
Proficiency with Microsoft Office applications, particularly Excel.
Working knowledge of HIPAA and healthcare compliance requirements.
Experience collaborating across departments on operational and customer-focused initiatives.
Experience creating and maintaining SOPs, process documentation, and operational guides.
Professional integrity and commitment to ethical decision-making.
Ability to achieve performance goals and deliver measurable revenue outcomes.

Nice To Haves

Associate's or Bachelor's degree.
Experience using Brightree.
Experience supporting complex reimbursement optimization initiatives across multiple payors or client portfolios.

Responsibilities

Own the revenue cycle performance of assigned clients and serve as their primary operational contact.
Ensure timely resolution of issues, risks, and escalations.
Manage accounts receivable, denials, appeals support, and revenue recovery activities to improve reimbursement outcomes.
Analyze payor and client data to identify trends, root causes, risks, and opportunities for improved financial performance.
Partner with global operations teams to monitor inventory, quality, productivity, and SLA adherence.
Develop and maintain provider guides, SOPs, and client-specific process documentation.
Educate internal teams on reimbursement requirements, workflows, and best practices.
Recommend and implement process, workflow, payer setup, and pricing improvements.
Lead cross-functional collaboration to resolve operational challenges and support client success.
Prepare and present reporting, deep-dive analyses, and recommendations.
Monitor compliance with Medicare, Medicaid, Commercial payer requirements, HIPAA, and internal policies, and escalate identified risks.
Maintain end-to-end ownership of action plans and customer outcomes through completion.