01Overview
Knack RCM is seeking a highly accomplished Associate Director DME Billing to lead end-to-end Durable Medical Equipment (DME) Revenue Cycle Management operations.
The role will be responsible for overseeing Insurance Verification, Prior Authorization, Intake, Billing, Accounts Receivable (AR), Denial Management, Payment Posting, Client Management, Compliance, and Operational Excellence initiatives.
The ideal candidate will possess strong leadership experience in DME Billing Operations, a deep understanding of payer guidelines, and a proven track record of driving revenue growth, operational efficiency, client satisfaction, and team development.
Role & responsibilities
Operational Leadership
Lead large-scale DME Billing operations across multiple clients and business units.
Ensure achievement of operational KPIs, quality standards, productivity targets, and SLAs.
Drive workforce planning, resource allocation, utilization, and capacity management.
Develop and execute strategic operational plans aligned with business objectives.
Lead and mentor Managers, Team Leads, and Operations teams.
Insurance Verification & Authorization Management
Oversee eligibility verification and benefits investigation processes.
Ensure accurate payer verification and documentation.
Monitor authorization turnaround times and approval rates.
Minimize eligibility and authorization-related denials through process improvements.
Billing & Claims Management
Ensure timely claim generation and submission.
Improve billing accuracy and clean claim rates.
Drive reduction in front-end errors and claim rejections.
Monitor billing productivity and operational performance.
Accounts Receivable Management
Manage Commercial, Medicare, Medicaid, and Managed Care AR portfolios.
Improve collections and reduce AR aging.
Ensure timely follow-up and resolution of unpaid and underpaid claims.
Drive initiatives to reduce outstanding inventories and improve cash flow.
Denial Management
Analyze denial trends and identify root causes.
Develop payer-specific denial prevention and recovery strategies.
Improve appeal success rates and denial recovery performance.
Collaborate with Quality and Training teams to minimize recurring denials.
Payment Posting
Ensure accurate and timely payment posting and reconciliation.
Identify underpayments and recovery opportunities.
Monitor revenue leakage and implement corrective measures.
Client Relationship Management
Serve as the primary operational contact for assigned DME clients.
Conduct Monthly Business Reviews (MBRs) and Quarterly Business Reviews (QBRs).
Present operational performance, revenue metrics, collection trends, and improvement plans.
Manage client escalations and foster long-term partnerships.
Support client retention and account growth initiatives.
Compliance & Quality
Ensure compliance with:
HIPAA Regulations
Medicare Guidelines
Medicaid Guidelines
Commercial Payer Policies
Internal Audit Requirements
Monitor process compliance and quality metrics.
Drive audit readiness and continuous quality improvement initiatives.
Financial & Revenue Management
Drive revenue maximization and collection improvement initiatives.
Monitor departmental profitability and cost performance.
Support budgeting, forecasting, and financial planning activities.
Identify automation opportunities that enhance ROI and operational efficiency.
Process Excellence & Transformation
Lead automation and digital transformation projects.
Implement Lean Six Sigma and continuous improvement initiatives.
Evaluate emerging technologies and workflow optimization opportunities.
Drive productivity enhancement and operational scalability.
Strategic Growth & Business Development
Support new client implementations and transitions.
Participate in RFP responses and solution design discussions.
Identify opportunities for service expansion and operational growth.
Partner with Sales and Business Development teams during client engagements.
Preferred candidate profile
Mandatory Requirements
12+ years of experience in DME Revenue Cycle Management.
Strong .
