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MedCare Equipment Company

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Manager, HME Revenue Cycle & Financial Analyst

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Description

The HME Revenue Cycle Manager/Financial Analyst is responsible for overseeing all revenue cycle operations for a Home Medical Equipment (HME) organization, ensuring accurate reimbursement, maximizing cash collections, minimizing denials, and providing financial analysis that supports strategic and operational decision-making. This role bridges revenue cycle management, reimbursement optimization, financial reporting, budgeting, and business analytics to improve profitability, cash flow, and operational performance. This combined role is particularly effective for mid-sized HME organizations because it links reimbursement performance directly to financial outcomes, allowing leadership to make data-driven decisions around payer strategy, referral capture, pricing, staffing, and profitability.


Essential Responsibilities:

Revenue Cycle Management

  • Direct all aspects of the revenue cycle including intake, insurance verification, authorization, billing, collections, cash posting, and accounts receivable management.
  • Ensure compliance with Medicare, Medicaid, commercial payer, and accreditation requirements.
  • Monitor key revenue cycle metrics including:
  • Days Sales Outstanding (DSO)
  • Net Collection Rate
  • Denial Rate
  • First-Pass Claim Acceptance Rate
  • Aging Accounts Receivable
  • Write-offs and Adjustments
  • Lead denial management initiatives and implement corrective actions to improve reimbursement.
  • Develop workflows and standard operating procedures to improve billing accuracy and collection performance.
  • Manage payer audits, RAC requests, ADRs, and documentation reviews.
  • Collaborate with Intake, Clinical, Sales, Compliance, and Operations teams to ensure clean claim submission and timely payment.
  • Oversee monthly revenue cycle performance reviews and reporting.

Financial Analysis & Reporting:

  • Prepare monthly financial and operational reports for executive leadership.
  • Analyze revenue, gross margin, reimbursement trends, and profitability by:
  • Product category
  • Referral source
  • Service line
  • Payer
  • Branch location
  • Develop financial models to assess business opportunities, reimbursement changes, and operational initiatives.
  • Monitor budget performance and identify opportunities for cost reduction and revenue enhancement.
  • Perform variance analysis between budget, forecast, and actual financial performance.
  • Create forecasting models for revenue, cash flow, reimbursement, and accounts receivable.
  • Support annual budgeting and strategic planning processes.

Business Intelligence & Data Analytics:

  • Develop dashboards and KPIs to monitor financial and operational performance.
  • Analyze billing trends, referral conversion rates, payer utilization, and reimbursement patterns.
  • Identify opportunities to improve:
  • Revenue capture
  • Billing efficiency
  • Collection performance
  • Referral retention
  • Operational productivity
  • Work with software platforms such as Brightree, Parachute, Power BI, Excel, Tableau, or equivalent reporting tools.
  • Present actionable recommendations to leadership based on data analysis.

Leadership & Team Management

  • Lead, mentor, and develop billing, collections, and revenue cycle staff.
  • Establish departmental goals and performance standards.
  • Ensure cross-functional collaboration between Revenue Cycle, Finance, Operations, Purchasing, and Customer Service teams.
  • Drive a culture of accountability, continuous improvement, and customer service excellence.

Skills

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