DME RCM Manager

About the Role

The DME RCM Manager will report directly to the Director, Revenue Cycle Management. This team member oversees and is responsible for the company's performance and results pertaining to Clearinghouse Rejections, Denials, AR, and Adjustments. In addition, this individual will engage in various projects, workflow and process improvement initiatives, technology enhancements, and partner with all business functions and teams across the organization.

Responsibilities

• Lead the day-to-day operations of the Revenue Cycle Management department with a focus on the company's performance and results pertaining to Clearinghouse Rejections, Denials, AR, and Adjustments.
• Manage the relationship and performance of assigned teams and third-party vendors responsible for working rejections, denials management, AR, and Adjustments.
• Monitor results, complete trending analysis, identify root causes, and proactively identify opportunities for improvement and communicate these with the appropriate leaders in RCM and across the organization.
• Develop, implement, and maintain operating policies and procedures ensuring consistency within other areas of Revenue Cycle.
• Work closely with finance and operations leaders to provide key operational insights into the RCM process and assist with cost controls and supplier payment integrity.
• Ensure all documentation supporting billing is obtained, is complete, and satisfies all payer requirements. In addition, ensure all qualification requirements are met and ensure compliance with third party payor requirements as well as all applicable state/federal laws and regulations.
• Perform additional job duties as assigned.

Qualifications

• Bachelor's degree, preferred.
• At least 5 years of DME experience in a leadership position required.
• DME expertise with Oxygen, PAP, Ventilators.
• At least 5 years of experience in revenue cycle management, including billing, payment posting, AR/denials management, and patient financial services.
• Expert understanding of DME products, qualification requirements, and government and commercial payer billing guidelines and requirements.
• Expert understanding of healthcare reimbursement/collections, medical billing, ICD10 coding, patient documentation, and state and federal regulations.
• Proficient in MS Office applications and ability to learn department and job-specific software systems (e.g., applicable practice management and EMR systems).
• Demonstrate organizational skills.
• Demonstrate effective verbal and written communication skills.
• Demonstrate analytical skills when problem-solving.
• Demonstrate high attention to detail and a high degree of accuracy.

What Sets You Apart

• Accountability: Demonstrates an understanding of the link between one's own job responsibilities and overall organizational goals and needs.
• Analytical Thinking: Demonstrates the ability to deconstruct information into smaller categories in order to draw conclusions.
• Decision Making: Manages to make the right decision in complex situations.
• Management and Leadership: Demonstrates the ability to influence and guide members of an organization.
• Result Oriented: Demonstrates knowledge in setting and achieving challenging goals.

Compensation

The base salary range for this position is $83,200 – $104,000 annually. This range reflects the anticipated compensation at the time of posting. Final compensation will be based on factors such as relevant experience, demonstrated skills, internal equity, and prevailing market conditions. Compensation discussions are encouraged throughout the hiring process.

Benefits

• Professional growth opportunities with compelling career paths.
• Healthy work-life balance supported by generous paid time off (PTO).
• Comprehensive benefits package, including medical, dental, vision, STD & LTD insurance for full-time team members.
• 401(k) savings plan with employer matching contributions.