Job Summary

We are seeking an experienced and results-driven Senior Manager – DME Operations to lead and manage large-scale Durable Medical Equipment (DME) Revenue Cycle Management (RCM) operations. The role will be responsible for driving operational excellence, revenue optimization, client satisfaction, team performance, and process transformation across DME billing functions.

The ideal candidate will possess solid expertise in DME Billing, Accounts Receivable (AR), Denial Management, Prior Authorization, Eligibility Verification, Documentation Compliance, Revenue Cycle Operations, Client Management, and Team Leadership. The incumbent will oversee multiple operational teams, drive process improvements, ensure compliance with regulatory requirements, and contribute to organizational growth through strategic execution and operational governance.

Key Responsibilities

Strategic & Operational Leadership

- Lead end-to-end DME billing operations across multiple client accounts and product categories.
- Develop and execute operational strategies to improve collections, productivity, quality, and customer satisfaction.
- Drive achievement of operational KPIs, SLAs, quality metrics, and financial targets.
- Conduct regular business reviews and operational governance meetings with internal and external stakeholders.
- Collaborate with senior leadership to align operational objectives with business goals.
- Support transitions, process migrations, and business expansion initiatives.

Accounts Receivable & Revenue Cycle Management

- Oversee DME Accounts Receivable portfolios across Medicare, Medicaid, Commercial Payers, and Managed Care Plans.
- Drive initiatives to reduce AR aging and improve cash collections.
- Lead Denial Management teams to maximize reimbursement and minimize revenue leakage.
- Monitor and improve key revenue cycle metrics including:

o AR Aging

o Days in AR

o Collection Rate

o Net Collection Ratio

o Denial Rate

o Claim Acceptance Rate

o First Pass Resolution

o Recovery Rate

o Productivity & Quality Metrics

- Analyze denial trends and implement corrective action plans.
- Ensure timely follow-up on outstanding claims and escalated accounts.




- Drive reimbursement optimization and revenue recovery initiatives.

DME Billing & Documentation Management

- Ensure compliance with DME-specific billing guidelines and payer requirements.
- Oversee processes related to:

o Prior Authorization

o Eligibility Verification

o Documentation Review

o Order Intake

o Claims Submission

o Payment Posting

o Accounts Receivable Follow-up

o Denial Management

o Appeals & Reconsiderations

- Ensure adherence to documentation requirements including CMNs, LMNs, physician orders, and payer-specific documentation standards.
- Work closely with clients to improve clean claim submission and reimbursement outcomes.

Client & Stakeholder Management

- Serve as the primary operational leader for client engagements and account governance.
- Lead Monthly Business Reviews (MBRs), Quarterly Business Reviews (QBRs), and client meetings.
- Present operational performance, collection trends, process improvement initiatives, and business insights.
- Build strong relationships with clients and stakeholders.
- Manage operational escalations and ensure timely resolution.
- Support account growth, client retention, and business development opportunities.

Leadership & People Management

- Lead large teams through Managers, Assistant Managers, Team Leads, and Supervisors.
- Drive workforce planning, staffing, capacity management, and productivity initiatives.
- Develop succession planning and leadership development programs.
- Conduct performance reviews and coaching sessions for team members.
- Foster a culture of accountability, collaboration, and continuous improvement.
- Drive employee engagement and retention initiatives.

Process Excellence & Transformation

- Lead automation and process improvement initiatives within DME operations.
- Implement Lean, Six Sigma,



and industry best practices to improve efficiency and quality.
- Partner with Quality, Training, Reporting, and Technology teams to enhance operational performance.
- Standardize workflows and implement governance frameworks across accounts.
- Drive transformation projects focused on scalability and operational excellence.

Compliance & Risk Management

- Ensure compliance with Medicare, Medicaid, HIPAA, and Commercial Payer regulations.
- Maintain audit readiness and support client audits and internal audits.
- Monitor operational risks and implement mitigation plans.
- Ensure adherence to client-specific policies and quality standards.
- Drive awareness of compliance requirements across teams.

EDUCATIONAL QUALIFICATIONS

- Graduate in any discipline
- Preferred:

o MBA / PGDM

o Healthcare Management

o Business Administration

o Hospital Administration

- Certifications in Revenue Cycle Management, Lean Six Sigma, Project Management, DME Billing, CPC, CPB, or related disciplines will be an added advantage.

Desired Candidate Profile

- 10–15 years of experience in US Healthcare Revenue Cycle Management.
- Minimum 7–10 years of experience in DME Billing and Accounts Receivable Operations.
- Strong expertise in:

o DME Billing

o Accounts Receivable Management

o AR Follow-up

o Denial Management

o Appeals & Reconsiderations

o Eligibility Verification

o Prior Authorization

o Claims Processing

o Payment Posting

o Revenue Recovery & Collections

o Medicare & Medicaid Regulations

o Commercial Insurance Billing

- Strong understanding of DMEPOS billing guidelines and reimbursement processes.
- Experience managing large operational teams of 400+ FTEs.
- Proven track record of improving collections, reducing AR aging, and enhancing operational performance.
- Experience managing client-facing engagements and stakeholder relationships.
- Strong analytical, communication, presentation, and leadership skills.
- Experience leading process transformation and operational improvement initiatives.
- Demonstrated ability to build, mentor, and retain high-performing teams.

📌 Senior Manager DME Operations (Sahibzada Ajit Singh Nagar)
🏢 IndiHire Consultants
📍 Sahibzada Ajit Singh Nagar