Senior Manager (DME)

TITLE: Senior Manager – DME Billing Operations

Location: MohaliExperience: 10–15 YearsPOSITION SUMMARYWe are seeking an experienced and results-driven Senior Manager – DME Billing Operations to lead and manage end-to-end Durable Medical Equipment (DME) Revenue Cycle Operations.

The role is responsible for driving operational excellence, maximizing collections, improving AR performance, ensuring client satisfaction, and developing high-performing teams.The ideal candidate will possess strong expertise in DME Billing, Accounts Receivable Management, Denial Management, Medicare/Medicaid Guidelines, Commercial Payer Processes, Client Management, and Team Leadership.The incumbent will play a critical role in driving operational efficiency, revenue optimization, process improvements, and organizational growth.KEY RESPONSIBILITIESOperations Management

• Lead end-to-end DME Billing operations, including Billing, AR Follow-up, Denial Management, Appeals, and Payment Posting.
• Drive productivity, quality, accuracy, and financial performance across DME operations.
• Monitor operational KPIs and implement action plans to achieve client and organizational goals.
• Ensure timely claim submission and effective AR management to maximize collections.
• Analyze operational trends and identify opportunities for process improvement and revenue enhancement.
• Drive operational governance through regular reviews, performance dashboards, and reporting mechanisms.Accounts Receivable & Revenue Cycle Management
• Oversee DME AR portfolios across Medicare, Medicaid, and Commercial Payers.
• Monitor AR aging and drive initiatives to improve collections and reduce outstanding receivables.
• Lead denial management and appeals processes to optimize recoveries.
• Track and manage key AR metrics including:o AR Agingo Collection Effectivenesso Days in ARo Denial Rateo Recovery Rateo Productivity Metricso Net Collection Ratio
• Conduct root cause analysis on denials and implement preventive actions.
• Ensure compliance with payer-specific billing requirements and reimbursement guidelines.Client & Stakeholder Management
• Serve as a key operational contact for client engagements and escalations.
• Participate in Monthly Business Reviews (MBRs) and Quarterly Business Reviews (QBRs).
• Present operational performance, collection trends, and process improvement initiatives.
• Build and maintain strong relationships with clients and internal stakeholders.
• Ensure adherence to client SLAs, KPIs, and contractual commitments.
• Collaborate with Quality, Training, Reporting, HR, and Technology teams to achieve operational objectives.Leadership & People Management
• Lead, mentor, and develop Managers, Assistant Managers, Team Leads, and AR Specialists.
• Manage workforce planning, staffing, capacity management, and resource allocation.
• Conduct performance reviews, coaching sessions, and development programs.
• Drive employee engagement, retention, and succession planning initiatives.
• Foster a culture of accountability, collaboration, innovation, and continuous improvement.
• Build leadership capability within the organization through ongoing mentoring and development.Process Excellence & Transformation
• Identify process improvement and automation opportunities across DME operations.
• Drive Lean, Six Sigma, and operational excellence initiatives.
• Implement best practices to improve productivity, quality, and collection outcomes.
• Support process transitions, migrations, and business expansion initiatives.
• Partner with technology teams to enhance workflow efficiency and reporting capabilities.
• Establish standardized operating procedures and governance frameworks.Compliance & Risk Management
• Ensure adherence to Medicare, Medicaid, Commercial Payer, HIPAA, and client-specific requirements.
• Maintain operational compliance and audit readiness.
• Identify operational risks and implement mitigation strategies.
• Ensure data security, confidentiality, and regulatory compliance across all processes.EDUCATIONAL QUALIFICATIONS
• Graduate in any discipline
• Preferred:o MBA / PGDMo Healthcare Managemento Hospital Administrationo Business Management
• Certifications in Healthcare Revenue Cycle Management, Lean Six Sigma, or related areas will be an added advantage.DESIRED CANDIDATE PROFILE
• 10–15 years of experience in US Healthcare Revenue Cycle Management.
• Minimum 5–7 years of experience managing DME Billing and Accounts Receivable Operations.
• Strong expertise in:o DME Billingo Accounts Receivable Managemento AR Follow-upo Denial Managemento Appeals & Reconsiderationso Medicare & Medicaid Billingo Commercial Insurance Billingo Revenue Recovery & Collections
• Experience managing large teams of 400+ FTEs.
• Proven track record of improving collections, reducing AR aging, and enhancing operational performance.
• Strong understanding of payer reimbursement methodologies and DME workflows.
• Excellent analytical, communication, presentation, and client management skills.
• Demonstrated success in leading high-performing teams and delivering client satisfaction.
• Strong people leadership and organizational development capabilities.KEY COMPETENCIES
• DME Revenue Cycle Management
• Accounts Receivable Management
• Denial & Appeals Management
• Medicare & Medicaid Expertise
• Commercial Payer Management
• Revenue Optimization
• Client Relationship Management
• People Leadership
• Operational Excellence
• Process Improvement
• Strategic Thinking
• Stakeholder Management
• Performance Management
• Team Building & Talent Development
• Change Management
• Financial & Business Acumen