Revenue Cycle Manager - DME

XRHEALTH INC; Needham (MA); On-site; USD 110,000 - 150,000; Full time

Benefits offered by this job

PTO

Comprehensive health insurance

401(k) plan

Additional benefits

Job summary

XRHealth Inc is seeking an experienced DME Revenue Cycle Manager to lead XRHealth America’s DME billing and reimbursement operations in Needham, MA. You will guide a hands-on team through eligibility, prior authorization, claims submission, denials, AR, and collections, ensuring accurate, compliant, and timely performance.

The ideal candidate has direct DME revenue cycle experience, strong leadership, and a track record of improving workflows and accuracy.

Qualifications

• Direct DME revenue cycle experience required.
• At least five years in DME or healthcare revenue cycle experience; includes leadership roles.
• Experience billing Medicare, Medicaid, Medicare Advantage, and commercial plans.
• Strong knowledge of DME billing policies, caps, documentation, and medical necessity.
• Experience managing claims, payment posting, denials, appeals, AR, and collections.
• Proficiency with HCPCS, ICD-10, modifiers, prior authorization, and timely filing.
• Ability to develop workflows, SOPs, and performance standards.
• Advanced proficiency with Microsoft Excel.

Responsibilities

• Lead day-to-day operations of the DME revenue cycle team.
• Oversee eligibility verification, prior authorizations, claims submission, posting, denials, AR, and collections.
• Drive denial prevention, root-cause analysis, and payer escalations.
• Develop and implement automation, AI, and system optimization initiatives.
• Ensure compliance with Medicare/Medicaid, HIPAA, and payer requirements.
• Collaborate with cross-functional teams to resolve billing and documentation issues.

Skills

DME revenue cycle

Healthcare revenue cycle

Management / team leadership

Medicare DME billing

Billing across payers

HCPCS/ICD-10 codes

SOPs and quality controls

Excel proficiency

Automation / AI awareness

Tools

DME billing systems & payer portals

Job description

We are looking for an experienced, analytical, and hands-on RCM Manager to lead the revenue cycle function for XRHealth America’s growing DME business.

XRHealth has a newly established revenue cycle team supporting the complete reimbursement process—from eligibility verification and prior authorization through claims submission, payment posting, denials, accounts receivable, and collections.

The RCM Manager will ensure the team’s work is completed accurately, efficiently, systematically, and in compliance with payer and regulatory requirements. This person will establish clear workflows, monitor quality and productivity, train and support team members, and create accountability for results.

As the business grows, the RCM Manager will also identify and implement opportunities for automation, AI, and system optimization. We are looking for a builder and hands-on leader who is comfortable working in the details while developing a scalable revenue cycle operation.

Direct DME revenue cycle experience is required.

Key Responsibilities

- Team and Operational Leadership

• 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 and knowledge gaps.
• Develop and maintain Standard Operating Procedures and quality-control processes.
• Support future hiring and team development as the business grows.

- Revenue Cycle Management

• 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, including Standard Written Orders, medical records, proof of delivery, prior authorizations, and continued-use documentation.
• Oversee DME rental billing, including recurring claims, capped-rental requirements, modifiers, and continued medical-necessity requirements.
• Ensure proper use of HCPCS codes, ICD-10 codes, modifiers, fee schedules, and payer-specific billing rules.
• Maintain current knowledge of DME MAC policies, LCDs, related policy articles, and payer requirements.
• Coordinate with Operations, Logistics, Customer Success, Finance, and Compliance to resolve billing and documentation issues.

- Denials and Accounts Receivable

• Lead denial prevention, root-cause analysis, appeals, and payer escalations.
• Monitor accounts receivable aging and ensure timely follow-up on unpaid and underpaid claims.
• Identify trends involving denials, payment delays, authorization failures, and avoidable write-offs.
• Oversee responses to medical-record requests, payer audits, recoupments, and overpayment notices.
• Implement corrective actions that improve collections and prevent recurring issues.

- Systems, Automation, and Reporting

• Evaluate existing processes and eliminate unnecessary manual work and inconsistent practices.
• Identify opportunities to use automation and AI to improve accuracy, productivity, claim follow-up, and reporting.
• Optimize workflows within NikoHealth and related clearinghouse, payer, financial, and reporting systems.
• Partner with Operations and Technology to improve system integrations and data integrity.
• Develop dashboards and report regularly on clean-claim rate, denial rate, days in accounts receivable, aging, collections, turnaround times, write-offs, and team productivity.
• Use revenue cycle data to identify risks and recommend operational improvements.

- Compliance

• Ensure compliance with Medicare, Medicaid, commercial payer, HIPAA, DMEPOS accreditation, and applicable federal and state requirements.
• Maintain controls related to billing accuracy, medical necessity, documentation, timely filing, overpayments, and claim adjustments.
• Partner with Compliance on internal audits, payer audits, TPE reviews, accreditation surveys, and regulatory requests.
• Translate regulatory and payer-policy changes into updated workflows and team training.

The Ideal Candidate

You are an experienced DME revenue cycle professional who understands both the details of the work and how to lead a team effectively.

You are organized, analytical, proactive, and comfortable bringing structure to a new operation. You set clear expectations, hold people accountable, and step into the details when necessary to solve problems.

You also look beyond the immediate workload. You identify ways to improve systems, automate repetitive tasks, reduce errors, and build processes that can support continued growth.

Qualifications

- Required

• Direct DME revenue cycle experience. 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, supervisory, or team-lead role.
• Strong knowledge of Medicare DME billing, DME MAC policies, capped rentals, documentation, proof of delivery, medical necessity, and continued-use requirements.
• Experience billing Medicare, Medicaid, Medicare Advantage, and commercial insurance plans.
• Experience managing claims, payment posting, denials, appeals, accounts receivable, and collections.
• Working knowledge of HCPCS codes, ICD-10 codes, modifiers, prior authorization, and timely-filing requirements.
• Experience developing workflows, SOPs, quality controls, and performance standards.
• Strong analytical, organizational, leadership, and problem-solving skills.
• Experience with DME billing systems, clearinghouses, payer portals, and reporting tools.
• Advanced proficiency with Microsoft Excel.
• Ability to work full-time on-site in Needham, Massachusetts.

- Preferred

• Experience with NikoHealth.
• Professional certification such as CRCR, CPC, CPB, or CMRS.
• Experience with Medicare TPE reviews, payer audits, recoupments, and overpayments.
• Experience implementing workflow automation, AI tools, or system integrations.
• Experience in a fast-growing DME, healthcare technology, or medical device company.
• Familiarity with NetSuite, HubSpot, Zendesk, or related business platforms.

Why Join XRHealth?

• PTO
• comprehensive health insurance
• a 401(k) plan
• additional benefits

This is a full-time, 100% on-site position based in Needham, Massachusetts.

About XRHEALTH INC

XRHealth is a global leader in immersive healthcare, providing FDA-registered, AI-powered virtual reality therapy solutions for physical, cognitive, and behavioral health.

Through XRHealth America, our U.S. commercialization business, we operate across several business lines, including accredited DME operations, commercialization, distribution, logistics, and strategic partnerships.