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.