Revenue Cycle Representative - Facilities Job at ResMed (Chennai)

Job Description

The Revenue Cycle Representative – Facilities (SNF & LTC) is responsible for supporting the end‑to‑end revenue cycle operations for Skilled Nursing Facility (SNF) and Long‑Term Care (LTC) services. This role performs a full range of activities including billing, cash posting, accounts receivable (A/R) follow‑up, and payer resolution. The representative ensures accurate and timely reimbursement by maintaining compliance with payer guidelines, resolving claim issues, and delivering high‑quality financial support to the organization.

Job Responsibility

Prepare, review, and submit electronic and paper claims for SNF and LTC services to Medicare, Medicaid, Managed Care plans, and commercial payers
Verify claim accuracy, including rates, patient liability, room and board charges, therapy services, and ancillary items
Monitor and resolve held, rejected, or denied claims prior to submission
Ensure billing compliance with regulatory requirements specific to SNF and LTC, including UB‑04 claim standards and state Medicaid guidelines
Coordinate with facility teams to reconcile documentation, correct billing issues, and ensure timely claim submission
Post all incoming payments, adjustments, and remittance information accurately and timely into the billing system
Reconcile daily deposits, EFTs, ERAs, and lockbox transactions
Identify and correct payment discrepancies, underpayments, and payer errors
Process and document refunds or recoupments in accordance with internal and regulatory standards
Maintain accurate cash logs and ensure proper month‑end balancing
Manage an assigned A/R portfolio to reduce outstanding balances and achieve department targets
Conduct follow‑up with payers on unpaid, denied, or delayed claims
Research claim statuses using payer portals, provider lines, and remittance details
Initiate appeals and reconsiderations with the appropriate documentation
Track and resolve authorization issues, eligibility discrepancies, and coverage conflicts affecting payment
Collaborate with facilities to obtain clinical documentation, medical records, or supporting materials needed for claim resolution
Maintain up‑to‑date knowledge of Medicare, Medicaid, and Managed Care SNF/LTC billing regulations
Follow HIPAA, regulatory, and organizational guidelines
Support audit initiatives by providing billing records, remittances, and payer correspondence
Document all actions accurately in the billing and A/R systems
Work closely with facility leadership, admissions, MDS teams, therapy providers, and case management to ensure billing accuracy
Communicate payer trends, denial patterns, and process improvement opportunities to leadership
Provide professional, timely responses to internal and external partners

Requirements

Education equivalent to a High school diploma, college degree preferred
Experience in healthcare revenue cycle operations, billing, cash posting, or A/R
Knowledge of UB‑04 billing, SNF/LTC payer rules, and basic accounting principles
Strong computer and EMR/billing software skills
Excellent attention to detail and organizational skills

Nice to have

1–2 years of SNF or LTC billing experience
Familiarity with Medicare A/B, Medicaid, Managed Care, and PDPM reimbursement
Experience with clearinghouses and payer portals
Working knowledge of medical terminology and billing codes

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Revenue Cycle Representative - Facilities

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