National Home Health Revenue & Credentialing Manager

Dhvaj; Oregon; Hybride; USD 90 000 - 130 000; Plein temps

Résumé du poste

MDOfficeManager is seeking a National Home Health RCM & Credentialing Manager with 3+ years in adult home health care, billing, and licensing operations across the United States. You will oversee revenue cycle, credentialing, and licensing, ensuring compliance and improved reimbursement performance.

The role requires coordinating nationwide credentialing and licensing, handling Medicare/Medicaid billing, and collaborating with clinical/administrative teams.

Qualifications

• Minimum of three years of hands-on experience in adult home health care or home health operations.
• Minimum of three years of experience in home health billing and revenue cycle management.
• Minimum of three years of experience in healthcare credentialing, payer enrollment, and licensing coordination.
• Demonstrated experience managing nationwide healthcare licensing and credentialing requirements across multiple U.S. states.
• Strong knowledge of Medicare, Medicaid, Medicare Advantage, and commercial insurance billing.
• Experience with home health claims processing, denial management, reimbursement, and accounts receivable.
• Working knowledge of provider credentialing, payer enrollment, license applications, and renewal processes.
• Understanding of state-specific healthcare regulations and applicable home health licensing requirements.
• Experience with electronic health records, medical billing platforms, and credentialing or licensing management systems.
• Strong organizational, analytical, communication, and problem-solving skills.
• Ability to manage multiple priorities and meet deadlines in a fast-paced healthcare environment.

Responsabilités

• Oversee end-to-end revenue cycle for adult home health services.
• Manage billing operations for Medicare, Medicaid, Medicare Advantage, and commercial insurance plans.
• Monitor revenue cycle performance and implement strategies to improve cash flow and reimbursement timelines.
• Analyze billing discrepancies, identify revenue leakage, and implement corrective measures.
• Track key performance indicators, including days in accounts receivable, claim denial rates, collection rates, and clean claim rates.
• Oversee denied, rejected, and underpaid claims and coordinate appeals and corrected claims.
• Review billing documentation to ensure compliance with applicable reimbursement guidelines.
• Coordinate enrollment with Medicare, Medicaid, and commercial insurance payers, as applicable.
• Maintain accurate credentialing records and establish standardized workflows for nationwide operations.
• Coordinate and oversee applicable healthcare licensing and regulatory requirements for operations across the United States.
• Develop and implement standard operating procedures for billing, credentialing, payer enrollment, and licensing.
• Collaborate with clinical, administrative, billing, and leadership teams to improve operational efficiency.
• Monitor departmental performance and prepare reports on revenue cycle results, credentialing status, and licensing compliance.
• Train and support team members on applicable billing, credentialing, licensing, and compliance procedures.

Connaissances

Home health billing

Revenue cycle management

Credentialing

Payer enrollment

Licensing coordination

Medicare/Medicaid knowledge

EHR systems

Data analysis

Regulatory compliance

Communication skills

Project management

Outils

Microsoft Excel

Healthcare reporting tools

Description du poste

MDOfficeManager is seeking a National Home Health RCM & Credentialing Manager with 3+ years in adult home health care, billing, and licensing operations across the United States. You will oversee revenue cycle, credentialing, and licensing, ensuring compliance and improved reimbursement performance.

The role requires coordinating nationwide credentialing and licensing, handling Medicare/Medicaid billing, and collaborating with clinical/administrative teams.