DME Revenue Cycle Lead — On-Site Needham, MA

XRHEALTH INC; Needham (MA); On-site; USD 110,000 - 160,000; Full time

Job summary

XRHealth Inc. in Needham, Massachusetts, seeks a hands-on Revenue Cycle Manager for the DME business.

You will lead the DME team, optimize workflows, ensure compliant claims submission, and drive improvements through automation and data analytics. Direct DME billing experience, Medicare/Medicaid knowledge, and strong Excel skills are essential as you build scalable processes and collaborate with Operations, Finance, and Compliance.

Qualifications

• Direct DME revenue cycle experience required (candidates without DME billing and reimbursement experience will not be considered).
• At least five years of DME or healthcare revenue cycle experience, including two or more years in a management/lead role.
• Strong knowledge of Medicare DME billing, DME MAC policies, capped rentals, documentation, and medical necessity.
• Experience billing Medicare, Medicaid, Medicare Advantage, and commercial plans.
• Experience managing claims, payment posting, denials, appeals, accounts receivable, and collections.
• Advanced proficiency with Microsoft Excel.
• Experience developing workflows, SOPs, and performance standards.

Responsibilities

• Lead the day-to-day work of the DME revenue cycle team.
• Establish clear workflows, responsibilities, priorities, productivity expectations, and quality standards.
• Monitor team performance and ensure work is completed accurately and on time.
• Train, coach, and support team members while addressing performance gaps.
• Develop and maintain SOPs and quality-control processes.
• Support future hiring and team development as the business grows.
• Oversee eligibility verification, intake review, prior authorization, documentation validation, claims submission, payment posting, denials, appeals, accounts receivable, and collections.
• Ensure accurate and timely claim submission to Medicare, Medicaid, Medicare Advantage, commercial insurers, and other payers.
• Confirm that claims are supported by required documentation (WO, medical records, etc.).
• Oversee DME rental billing, including recurring claims and continued-use requirements.
• Ensure proper use of HCPCS/ICD-10 codes, modifiers, fee schedules, and payer-specific rules.
• Maintain knowledge of DME MAC policies and payer requirements.
• Coordinate with Ops, Logistics, Finance, Compliance to resolve issues.
• Lead denial prevention, root-cause analysis, appeals, and payer escalations.
• Monitor accounts receivable aging and ensure timely follow-up.
• Identify trends in denials and write-offs and implement corrective actions.
• Oversee responses to medical-record requests, payer audits, recoupments, and overpayments.
• Implement actions improving collections.
• Evaluate processes and eliminate manual work; identify automation opportunities.
• Develop dashboards and regularly report on clean-claim rate, denial rate, aging, collections, and productivity.
• Use data to identify risks and suggest improvements.
• Translate regulatory changes into updated workflows and training.

Skills

DME Revenue Cycle

Healthcare Revenue Cycle

Medicare DME Billing

HCPCS Codes

ICD-10 Codes

Prior Authorization

Workflow Development

SOP Development

Quality Control

Excel

Team Leadership

Tools

DME Billing Systems

Clearinghouses

Payer Portals

Reporting Tools

NetSuite

HubSpot

Zendesk

Job description

XRHealth Inc. in Needham, Massachusetts, seeks a hands-on Revenue Cycle Manager for the DME business.

You will lead the DME team, optimize workflows, ensure compliant claims submission, and drive improvements through automation and data analytics. Direct DME billing experience, Medicare/Medicaid knowledge, and strong Excel skills are essential as you build scalable processes and collaborate with Operations, Finance, and Compliance.