The Senior Manager, Revenue Recognition is responsible for the people, processes and systems that move an order from delivery to a clean, billable claim. This position owns stop and held revenue, order confirmation and quality review, initial claim pass rate, and reauthorizations across all company locations, joint ventures and payors. The Senior Manager sets performance standards and priorities for these functions and is accountable for the timeliness and accuracy of revenue recognition, the reduction of held revenue and front-end denials, and compliance with all applicable rules and regulations, while striving for service excellence and company financial goals.

ESSENTIAL FUNCTIONS:

1. Owns the company's stop and held revenue inventory across all locations and joint ventures. Sets targets for held dollars, aging and days-to-release and is accountable for achieving them.

2. Directs the daily management of held-order work queues in the billing system, ensuring orders held for missing or invalid information are routed, worked and released in priority order and within payor timely filing limits.

3. Analyzes hold volume by reason, location, payor, product line and referral source to identify root causes. Partners with intake, operations and branch leadership to correct issues at the point of origin and prevent repeat holds.

4. Oversees sales order confirmation and quality review, ensuring each order meets payor documentation, medical necessity, coverage and proof-of-delivery requirements before revenue is recognized and the claim is released.

5. Establishes quality review standards, audit sampling methodology and error scoring. Reports results by individual, team and department and drives corrective action and retraining.

6. Accountable for initial claim pass rate, including clearinghouse acceptance and payor first-pass adjudication. Monitors rejections and front-end denials by payor, reason and product and implements corrective measures.

7. Translates changes in payor policy, coverage criteria and billing requirements into updated confirmation requirements, system rules and staff training in advance of effective dates.

8. Directs the reauthorization program for rental and recurring orders, ensuring prior authorizations, prescriptions and recertification documentation are renewed before expiration to prevent held revenue, denials and interruptions in patient service.

9. Monitors reauthorization timeliness and revenue at risk. Escalates payor and referral source barriers and negotiates process improvements with internal and external partners.

10. Develops and publishes key performance indicators for held revenue dollars and aging, confirmation turnaround, quality review accuracy, initial claim pass rate and reauthorization timeliness. Presents results, trends and action plans to senior leadership.

11. Partners with Finance on month-end close, revenue forecasting and held or unbilled revenue analysis. Explains variances and provides reliable projections of revenue release.

12. Collaborates with accounts receivable leadership to convert back-end denial and write-off trends into front-end process, rule and training changes.

13. Leads the supervisors and staff of the department. Responsible for hiring, training, coaching, development, performance measurement and discipline within company guidelines, with emphasis on developing next level leaders.

14. Sets staffing models and productivity and quality standards for the department. Recommends staffing structure, salary adjustments, transfers, promotions and dismissals.

15. Maintains departmental compliance with all applicable laws, rules, regulations and policies, including but not limited to Medicare, Medicaid and commercial payor requirements, HIPAA and The Joint Commission guidelines.

16. Leads or represents the department in cross-functional initiatives, including system changes, process standardization and the onboarding of new locations, joint ventures and payors.

17. Escalates and directs department activities during outages, systems issues, staffing shortages and other operational issues. Enacts contingency plans as needed.

18. Keeps immediate supervisor promptly and fully informed of all problems or unusual matters of significance and takes prompt corrective action where necessary or recommends alternative courses of action.

19. Maintains a favorable working relationship with other company employees to foster and promote a cooperative and harmonious working climate conducive to maximum employee morale, productivity, efficiency and effectiveness.

20. Other duties as assigned.

REQUIRED EDUCATION AND/OR EXPERIENCE:

1. Bachelor's degree in business, healthcare administration, finance or a related field, or equivalent combination of education and experience.

2. Five years of progressive healthcare revenue cycle experience, including three years leading supervisors or multi-function teams.

3. Working knowledge of Medicare, Medicaid and commercial payor documentation, authorization and billing requirements.

4. Demonstrated record of improving revenue cycle performance metrics through

process, system and people changes.

PREFERRED EDUCATION AND/OR EXPERIENCE:

1. Three years in a durable medical equipment (DME/HME) revenue cycle leadership role.

2. Experience with Brightree, including work queues, validation rules and reporting.

3. Experience in a multi-location or joint venture environment.

4. One year DASCO experience

ADDITIONAL QUALIFICATIONS:

1. Proficiency in Microsoft Office suite, including advanced Excel.

2. Ability to analyze large data sets and present findings and recommendations to senior leadership.

COMPETENCIES:

Analytical thinking

Detail oriented

Developing others

Financial management

Process improvement

Results driven

Strategic thinking

Stress management

POSITION TYPE/EXPECTED HOURS OF WORK:

This is a full-time position, and hours of work and days are Monday through Friday, typically 8:00 a.m. to 5:00 p.m. Occasional evening and weekend work may be required as job duties demand.

SUPERVISORY RESPONSIBILITY:

This position leads the Revenue Recognition department, including direct supervision of its supervisors and leads and indirect responsibility for all department staff. Responsibilities include hiring, development, performance management and discipline within company and department guidelines.

WORK ENVIRONMENT:

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

The employee is generally required to sit; frequently stands, may climb or balance; and stoop, kneel, crouch or crawl. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include both close and distance vision, color and peripheral vision, depth perception and ability to adjust focus.

TRAVEL:

Minimal travel is required for this position but occasional out of town and overnight travel may be expected.

OTHER DUTIES:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

EEO STATEMENT:

DASCO provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, DASCO complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

DASCO expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of DASCO’s employees to perform their job duties may result in discipline up to and including discharge.

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