Key Responsibilities
• Lead and mentor a team of billing specialists with accountability for results, quality, and development
• Oversee the full revenue cycle: claims, denials, collections, appeals, and payment posting
• Manage all payer credentialing and contracting across commercial and government programs
• Ensure all state DME licenses are applied for, maintained, and compliant
• Monitor A/R, aging reports, and denial trends; implement action plans to reduce days outstanding
• Conduct internal audits and ensure compliance with CMS, HIPAA, and payer regulations
• Analyze data and generate performance reports for leadership decision-making
• Collaborate cross-functionally with Admin, Sales, Service, and Finance to improve billing workflows
• Guide billing processes for new products or services and regulatory changes
What You Bring to the Table
Must-Have Qualifications
• 5+ years of healthcare billing experience, DME required
• 2+ years in a leadership or supervisory role
• Strong working knowledge of DMEPOS, HCPCS codes, modifiers, and billing documentation
• Proficiency in payer contracting, credentialing, and revenue cycle best practices
• Solid understanding of CMS-1500, insurance guidelines, and HIPAA compliance
• Advanced skills in Excel, billing systems, and reporting tools
• Proven ability to lead and motivate a team to hit performance and compliance targets
Preferred
• Bachelor’s degree in healthcare administration, business, or a related field
• Certification (Certified Professional Coder-CPC, Certified Medical Reimbursement Specialist- CMRS, or Certified Coding Specialist- CCS)
• Experience with payer negotiations and audit response strategies