Manager, HME Revenue Cycle & Financial… at MedCare… · Greensburg

The HME Revenue Cycle Manager/Financial Analyst is responsible for overseeing all revenue cycle operations for a Home Medical Equipment (HME) organization, ensuring accurate reimbursement, maximizing cash collections, minimizing denials, and providing financial analysis that supports strategic and operational decision-making. This role bridges revenue cycle management, reimbursement optimization, financial reporting, budgeting, and business analytics to improve profitability, cash flow, and operational performance. This combined role is particularly effective for mid-sized HME organizations because it links reimbursement performance directly to financial outcomes, allowing leadership to make data-driven decisions around payer strategy, referral capture, pricing, staffing, and profitability.

Essential Responsibilities:

Revenue Cycle Management

• Direct all aspects of the revenue cycle including intake, insurance verification, authorization, billing, collections, cash posting, and accounts receivable management.
• Ensure compliance with Medicare, Medicaid, commercial payer, and accreditation requirements.
• Monitor key revenue cycle metrics including:
• Days Sales Outstanding (DSO)
• Net Collection Rate
• Denial Rate
• First-Pass Claim Acceptance Rate
• Aging Accounts Receivable
• Write-offs and Adjustments
• Lead denial management initiatives and implement corrective actions to improve reimbursement.
• Develop workflows and standard operating procedures to improve billing accuracy and collection performance.
• Manage payer audits, RAC requests, ADRs, and documentation reviews.
• Collaborate with Intake, Clinical, Sales, Compliance, and Operations teams to ensure clean claim submission and timely payment.
• Oversee monthly revenue cycle performance reviews and reporting.

Financial Analysis & Reporting:

• Prepare monthly financial and operational reports for executive leadership.
• Analyze revenue, gross margin, reimbursement trends, and profitability by:
• Product category
• Referral source
• Service line
• Payer
• Branch location
• Develop financial models to assess business opportunities, reimbursement changes, and operational initiatives.
• Monitor budget performance and identify opportunities for cost reduction and revenue enhancement.
• Perform variance analysis between budget, forecast, and actual financial performance.
• Create forecasting models for revenue, cash flow, reimbursement, and accounts receivable.
• Support annual budgeting and strategic planning processes.

Business Intelligence & Data Analytics:

• Develop dashboards and KPIs to monitor financial and operational performance.
• Analyze billing trends, referral conversion rates, payer utilization, and reimbursement patterns.
• Identify opportunities to improve:
• Revenue capture
• Billing efficiency
• Collection performance
• Referral retention
• Operational productivity
• Work with software platforms such as Brightree, Parachute, Power BI, Excel, Tableau, or equivalent reporting tools.
• Present actionable recommendations to leadership based on data analysis.

Leadership & Team Management

• Lead, mentor, and develop billing, collections, and revenue cycle staff.
• Establish departmental goals and performance standards.
• Ensure cross-functional collaboration between Revenue Cycle, Finance, Operations, Purchasing, and Customer Service teams.
• Drive a culture of accountability, continuous improvement, and customer service excellence.

Qualifications:

Education:

• Bachelor's degree in Finance, Accounting, Healthcare Administration, Business Administration, or related field required.
• MBA, CPA, HFMA, or equivalent certification preferred.

Experience:

• 5+ years of progressive revenue cycle leadership experience.
• 3+ years of financial analysis, budgeting, or healthcare finance experience.
• Strong understanding of HME/DME reimbursement and billing regulations.
• Experience with Medicare, Medicaid, Managed Care, and Commercial Insurance billing.
• Experience with Brightree or comparable HME software preferred.

Knowledge, Skills & Abilities:

• Advanced Excel skills including pivot tables, complex formulas, and financial modeling.
• Strong analytical and problem-solving capabilities.
• Knowledge of HME reimbursement methodologies.
• Experience creating executive-level dashboards and financial reports.
• Understanding of healthcare compliance and regulatory requirements.
• Strong communication and presentation skills.
• Ability to manage multiple priorities in a fast-paced environment.

Key Performance Indicators (KPIs):

• Days Sales Outstanding (DSO)
• Net Collection Percentage
• Denial Rate
• First-Pass Claims Acceptance Rate
• A/R >90 Days Percentage
• Cash Collections to Target
• Gross Margin by Product Category
• Revenue Forecast Accuracy
• Budget Variance Performance
• Productivity Metrics per Billing FTE