Manager, HME Revenue Cycle & Financial Analyst
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.
Requirements

Qualifications:

Education:

  • Bachelor's degree in Finance, Accounting, Healthcare Administration, Business Administration, or related field required.
  • MBA, CPA, HFMA, or equivalent certification preferred.

Experience:

  • 5+ years of progressive revenue cycle leadership experience.
  • 3+ years of financial analysis, budgeting, or healthcare finance experience.
  • Strong understanding of HME/DME reimbursement and billing regulations.
  • Experience with Medicare, Medicaid, Managed Care, and Commercial Insurance billing.
  • Experience with Brightree or comparable HME software preferred.

Knowledge, Skills & Abilities:

  • Advanced Excel skills including pivot tables, complex formulas, and financial modeling.
  • Strong analytical and problem-solving capabilities.
  • Knowledge of HME reimbursement methodologies.
  • Experience creating executive-level dashboards and financial reports.
  • Understanding of healthcare compliance and regulatory requirements.
  • Strong communication and presentation skills.
  • Ability to manage multiple priorities in a fast-paced environment.

Key Performance Indicators (KPIs):

  • Days Sales Outstanding (DSO)
  • Net Collection Percentage
  • Denial Rate
  • First-Pass Claims Acceptance Rate
  • A/R >90 Days Percentage
  • Cash Collections to Target
  • Gross Margin by Product Category
  • Revenue Forecast Accuracy
  • Budget Variance Performance
  • Productivity Metrics per Billing FTE