Assistant Manager DME Billing RCM

Role & responsibilities

Operations Management

• Manage end-to-end DME Billing operations and ensure achievement of productivity, quality, collections, and financial targets.
• Oversee Billing, AR Follow-up, Denial Management, Payment Posting, and Appeals functions.
• Monitor operational KPIs, SLAs, and performance metrics.
• Drive process improvements to enhance operational efficiency and service delivery.
• Ensure timely claim submission and maximize collections through effective AR management.
• Analyze operational performance and implement corrective action plans.

Team Leadership & People Management

• Lead, mentor, and develop Team Leads, Senior Associates, and Billing Specialists.
• Manage workforce planning, capacity utilization, and resource allocation.
• Conduct performance reviews, coaching, and development programs.
• Drive employee engagement and retention initiatives.
• Build succession plans and create future leaders within operations.
• Foster a performance-driven and collaborative work culture.

Client & Stakeholder Management

• Act as a key point of contact for internal stakeholders and client interactions.
• Present operational reviews, productivity reports, collection performance, and improvement plans.
• Ensure adherence to client SLAs, KPIs, and contractual commitments.
• Manage client escalations and ensure timely resolution.
• Collaborate with Quality, Training, HR, Reporting, and Support teams.

Revenue Cycle Management

• Drive initiatives to improve collections and reduce AR aging.
• Monitor denial trends and implement effective recovery strategies.
• Ensure compliance with Medicare, Medicaid, HIPAA, and Commercial Payer guidelines.
• Review root causes of denials and implement corrective action plans.
• Monitor reimbursement trends and identify opportunities for revenue enhancement.

Process Excellence

• Identify and implement automation and workflow optimization opportunities.
• Participate in client transitions, process migrations, and new implementations.
• Drive Lean, Six Sigma, and operational excellence initiatives.
• Standardize processes and implement best practices across teams.
• Support continuous improvement and transformation projects.

Preferred candidate profile

Mandatory Requirements

8-12 years of experience in US Healthcare Revenue Cycle Management.

Minimum 3-5 years of experience in DME Billing Operations.

Minimum 2 years of experience managing Team Leads and operational teams.

Experience handling teams of 35-85+ FTEs.

Strong understanding of:

• DME Billing
• Accounts Receivable (AR)
• Denial Management
• Payment Posting
• Appeals Management
• Medicare & Medicaid Billing
• Commercial Payer Guidelines
• Revenue Cycle Management

Strong client management and stakeholder management experience.

Excellent communication, analytical, and leadership skills.

Proven track record of improving operational performance, collections, and revenue outcomes.

Educational Qualifications

UG: Any Graduate

Preferred:

• MBA
• PGDM
• Healthcare Management
• Equivalent Postgraduate Qualification

Additional Advantage:

• Revenue Cycle Management Certifications
• Lean Six Sigma Certification