RCM Pricing and Payor Coordinator

Brightree is a wholly owned subsidiary of Res Med (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.

The Implementation & Price Table Specialist is a highly motivated self-starter who is also detailed-oriented and understands the Brightree Platform and the pricing features. Industry experience with insurance billing and DME inventory products/coding is essential. Specialists will receive and process price table requests regarding creation, updating, and research. In addition, the specialist will analyse , identify , and help resolve pricing and software issues related to correct billing procedures.

Their objective is to improve the efficiency and accuracy of RCM customer claims and AR values reported. They are responsible for carrying out the physical pricing updates and managing project completion. The specialist should be a team player who can communicate effectively both verbally and in written communication with customers and troubleshoot pricing scenarios.

• Analyse and process price table updates and requests for RCM customers.

• Ensure accuracy and integrity of existing price tables.

• Create new price table requests for new RCM customer contracts.

• Maintain and update price tables for Brightree RCM customers.

• Manage price table requests through Smart Sheet & Salesforce.

• Assist the RCM team with pricing and billing questions.

• Communicate with stakeholders and RCM customers on price table requests/updates.

• Provide best practice direction on common price table issues.

• Prepare and submit client reports as needed.

• Research insurance billing requirements and fee schedules.

• Perform price table analyses as needed.

• Understand general rules, guidelines, and methods for payor payments.

• Follow policies, procedures, and systems for quality assurance as directed by Medicare, Medicaid, and private insurance.

• Ensure adherence to objectives , operating policies, procedures, and strategic action plans.

• Update Department SOPs, ensuring compliance, best practices, proper format, and appropriate links before publishing.

• Lead intake of customer concerns and provide recommendations to the manager for resolution.

• Manage escalations and act as the Brightree software SME for Price Table s , communicating directly with customer executives, directors, and management staff on price table requests/updates.

• Serve as an SME/Mentor to teammates, assisting with education and training.

• High School degree required, college coursework a plus.

• Minimum of 1-2 years of healthcare billing or customer service experience.

• Minimum of 1 year in a customer support environment.

• Computer literate and proficient with Microsoft Office Suite (Outlook, Word, and Excel).

• Knowledgeable in federal and state laws and requirements relating to healthcare management and billing for DME/HME.

• Excellent attention to detail and ability to investigate and troubleshoot price table issues, finding workarounds as needed.

• Strong ethics and a high level of personal and professional integrity.

• Exceptional organizational skills with the ability to multitask within multiple client databases.

• Quick learner, pleasant, and dedicated to providing a positive customer experience.

• Ability to work in a fast-paced, challenging environment with minimal supervision.

• Strong interpersonal, communication, and customer service skills with the ability to resolve challenging issues promptly.

• Experience using the following applications/software:
  Teams, SharePoint, Smart Sheet, Salesforce.

• Advanced proficiency in Microsoft Excel.

• Brightree Price Table knowledge/experience.

We are shaping the future at Res Med, and we recognize the need to build on and broaden our existing…