Associate Director DME Billing RCM

Knack RCM; Jaipur; On-site; INR 4,000,000 - 7,000,000; Full time

Job summary

Knack RCM is seeking a highly accomplished Associate Director DME Billing to lead end-to-end Durable Medical Equipment (DME) Revenue Cycle Management operations. You will oversee Insurance Verification, Prior Authorization, Intake, Billing, AR, Denial Management, Payment Posting, Client Management, Compliance, and Operational Excellence initiatives.

The ideal candidate will bring 12+ years in DME Revenue Cycle Management and a proven track record of driving revenue growth, client satisfaction,

Qualifications

• 12+ years of experience in DME Revenue Cycle Management.
• Strong leadership experience managing large-scale DME Billing operations.
• Proven success in Insurance Verification, Authorizations, Billing, AR, Denial Management, and Payment Posting.
• Deep understanding of Medicare, Medicaid, Commercial Payer, and Managed Care processes.
• Experience managing client relationships and business reviews.
• Strong analytical, financial, operational, and people leadership skills.

Responsibilities

• Lead large-scale DME Billing operations across multiple clients and business units.
• Ensure achievement of 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.
• Oversee eligibility verification and benefits investigation processes.
• Monitor authorization turnaround times and approval rates.
• Minimize eligibility and authorization-related denials through process improvements.
• Ensure timely claim generation and submission; improve billing accuracy.
• Drive reduction in front-end errors and claim rejections; monitor performance.
• Manage Commercial, Medicare, Medicaid, and Managed Care AR portfolios.
• Improve collections and reduce AR aging; ensure follow-up on unpaid claims.
• Analyze denial trends and develop payer-specific prevention strategies.
• Improve appeal success rates and denial recovery performance.
• Collaborate with Quality and Training teams to minimize recurring denials.
• Ensure accurate and timely payment posting and reconciliation.
• Identify underpayments and recovery opportunities; monitor revenue leakage.
• Present operational performance and revenue metrics in MB Rs / QBRs.
• Manage client escalations and foster long-term partnerships.

Skills

DME Billing Leadership

Revenue Cycle

Insurance Verification

Prior Authorization

AR Management

Denial Management

Payment Posting

Client Management

Compliance

Operational Excellence

Job description

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 leadership experience managing large-scale DME Billing operations.

Proven success in leading Insurance Verification, Authorizations, Billing, AR, Denial Management, and Payment Posting functions.

Deep understanding of Medicare, Medicaid, Commercial Payer, and Managed Care processes.

Experience managing client relationships and business reviews.

Strong analytical, financial, operational, and people leadership skills.

Experience driving process transformation, automation, and operational excellence initiatives.