Home Health RCM Manager

Company: MDOfficeManager
Location: Clarksville, Indiana
Job Type: Full-Time
Work Schedule: Monday–Friday, 8:00 AM–5:00 PM
Work Arrangement: On-site or Remote (depending on qualifications and business needs)
Salary: To Be Determined (TBD)

Job Summary

MDOfficeManager is seeking an experienced and detail-oriented Home Health Revenue Cycle Management (RCM) Manager to oversee and optimize the revenue cycle operations for home health services. This role is responsible for managing billing, claims processing, reimbursement, accounts receivable, payment posting, denial management, and revenue cycle performance.

The ideal candidate will have a strong understanding of home health billing regulations, Medicare and Medicaid reimbursement requirements, insurance claims processing, and revenue cycle best practices. The RCM Manager will work closely with clinical, administrative, and billing teams to ensure accurate billing, timely reimbursements, regulatory compliance, and efficient revenue cycle operations.

Key Responsibilities

Revenue Cycle Management

• Oversee the complete revenue cycle process, including patient eligibility verification, authorization, billing, claims submission, payment posting, accounts receivable, and collections.
• Develop and implement strategies to improve revenue cycle efficiency, cash flow, and reimbursement performance.
• Monitor key performance indicators (KPIs), including days in accounts receivable, denial rates, clean claim rates, and collection rates.
• Identify revenue leakage and implement corrective measures to maximize reimbursement.

Home Health Billing and Reimbursement

• Manage billing operations for home health services, including Medicare, Medicaid, Medicare Advantage, and commercial insurance plans.
• Ensure accurate and timely submission of claims in accordance with applicable payer requirements.
• Oversee the management of home health billing documentation, including physician orders, certifications, recertifications, and other supporting records required for reimbursement.
• Maintain an understanding of home health billing guidelines, including applicable Medicare requirements and billing regulations.
• Coordinate with clinical and administrative teams to resolve documentation gaps that may delay claims processing or reimbursement.

Denial Management and Accounts Receivable

• Monitor denied, rejected, and underpaid claims and ensure timely follow-up and resolution.
• Analyze denial trends, identify root causes, and implement preventive measures.
• Oversee accounts receivable aging reports and establish effective follow-up procedures.
• Coordinate appeals, reconsiderations, and corrected claims as needed.
• Develop strategies to reduce outstanding receivables and improve collections.

Team Leadership and Operations

• Supervise and support billing specialists, payment posters, accounts receivable representatives, and other revenue cycle personnel.
• Establish departmental goals, productivity standards, and performance metrics.
• Provide training and guidance on home health billing procedures, payer requirements, and compliance standards.
• Develop and maintain standard operating procedures to improve accuracy and operational consistency.
• Collaborate with leadership to identify process improvements and support business objectives.

Compliance and Reporting

• Ensure revenue cycle activities comply with applicable federal and state regulations, payer policies, and organizational procedures.
• Maintain appropriate safeguards for protected health information (PHI) in accordance with HIPAA requirements.
• Prepare and present regular reports on revenue cycle performance, reimbursement trends, denial rates, and accounts receivable.
• Support internal audits and payer audits by ensuring billing records and supporting documentation are accurate and accessible.
• Stay informed about changes in Medicare, Medicaid, and commercial payer billing requirements that affect home health services.

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field preferred.
• Minimum of 3–5 years of experience in revenue cycle management, medical billing, or healthcare reimbursement.
• Previous experience managing revenue cycle operations for a home health agency is strongly preferred.
• Demonstrated knowledge of Medicare, Medicaid, Medicare Advantage, and commercial insurance billing.
• Experience with claims management, denial resolution, payment posting, collections, and accounts receivable management.
• Familiarity with home health billing requirements, including applicable Medicare certification and documentation guidelines.
• Experience using electronic health records (EHR), billing platforms, and revenue cycle management systems.
• Prior supervisory or team management experience preferred.
• Strong analytical, organizational, problem-solving, and communication skills.
• Ability to manage multiple priorities and meet deadlines in a fast-paced healthcare environment.

Preferred Skills

• Expertise in home health revenue cycle workflows and reimbursement processes.
• Strong knowledge of claim denials, appeals, underpayments, and accounts receivable follow-up.
• Proficiency in Microsoft Excel, reporting tools, and billing management software.
• Ability to analyze financial data and develop actionable performance improvement plans.
• Experience developing policies, procedures, and workflows to improve billing accuracy and reimbursement timelines.
• Ability to work independently and collaborate effectively with clinical, administrative, and leadership teams.

Work Schedule and Location

• Employment Type: Full-Time
• Schedule: Monday through Friday, 8:00 AM–5:00 PM
• Location: Clarksville, Indiana
• Remote Work: Remote arrangements may be considered based on qualifications, experience, and business needs.
• Compensation: Salary to be determined based on experience and qualifications.

Equal Employment Opportunity

MDOfficeManager is committed to providing equal employment opportunities to all qualified applicants. Employment decisions are made without regard to protected characteristics in accordance with applicable federal, state, and local laws.