Manager, RCM Reimbursement

The Revenue Cycle Management (RCM) Reimbursement Manager provides strategic leadership and oversight for all reimbursement, billing, collections, denial management, and revenue optimization activities across the revenue cycle continuum. This role partners closely with Operations, Clinical Services, Sales, Intake, Insurance Verification, Customer Service, Finance, Compliance, and external payors to drive reimbursement performance, maximize cash collections, improve revenue integrity, and reduce financial risk.

The Manager is responsible for developing and executing revenue cycle strategies that support organizational financial goals, ensuring efficient reimbursement processes, regulatory compliance, operational excellence, and a best-in-class patient and customer experience. This role leads internal teams and vendor partnerships while utilizing data analytics and cross-functional collaboration to improve revenue capture, reduce denials, accelerate cash flow, and achieve enterprise-wide revenue cycle performance objectives.

Major Areas of Accountability

Leadership & Team Management:

• Develop and execute revenue cycle strategies designed to improve reimbursement performance, accelerate cash collections, and maximize net revenue.
• Establish departmental goals and key performance indicators aligned with organizational financial objectives.
• Partner with senior leadership to identify revenue opportunities, mitigate reimbursement risks, and improve overall financial performance.
• Lead initiatives focused on revenue integrity, denial prevention, process standardization, and cash acceleration.
• Drive accountability across departments to ensure successful reimbursement outcomes throughout the patient lifecycle.
• Manage and support billing and collections teams, including vendor liaisons, to ensure efficient workflow and timely resolution of accounts.
• Train and onboard new team members; monitor performance and provide ongoing coaching and development.
• Ensure adherence to departmental policies, HIPAA and PHI regulations, and corporate compliance standards.

Cross-Functional Partnership:

• Collaborate with Operations, Intake, Clinical Services, Insurance Verification, Customer Service, Sales, Finance, Compliance, and Technology teams to optimize end-to-end revenue cycle performance.
• Lead cross-functional efforts to identify and resolve root causes of reimbursement delays, billing errors, authorization issues, and documentation deficiencies.
• Serve as a key business partner to operational leaders regarding reimbursement trends, cash collection opportunities, and revenue cycle improvement initiatives.
• Facilitate alignment among departments to improve clean claim rates, authorization compliance, documentation quality, and overall reimbursement outcomes.

Financial & Performance Management

• Monitor and manage departmental performance against cash collection goals, net collection rates, denial reduction targets, accounts receivable aging, and reimbursement metrics.
• Support the development of forecasting models and reporting tools to support cash flow planning and executive decision-making.
• Present revenue cycle performance, reimbursement trends, financial risks, and improvement opportunities to senior leadership.
• Ensure effective management of vendor performance and contractual expectations to support organizational revenue objectives

• Oversee billing, collections, and reimbursement functions, including claim submissions, payment posting, denial management, and patient responsibility determinations.
• Review and resolve claim rejections and exceptions; ensure appropriate follow-up on aged accounts and outstanding A/R.
• Utilize knowledge of payer policies, DME billing guidelines, and coding (ICD, CPT, HCPCS) to ensure clean claim submission and low denial rates.
• Manage relationships with external collection vendors, ensuring compliance with contractual obligations and alignment with performance goals. .
• Generate, analyze, and distribute key performance reports on production, inventory, aged accounts, denial trends, and vendor performance.
• Monitor team productivity and identify areas for process improvement; assist with implementation of new tools and technologies.
• Develop and utilize data analytics (including Excel and Power BI) to develop actionable insights and support decision-making.

Process Improvement & Technology Leadership:

• Champion automation, technology enhancements, and system optimization initiatives that improve productivity, reimbursement accuracy, and operational efficiency.
• Lead process redesign efforts focused on reducing manual work, eliminating barriers to reimbursement, and improving patient financial outcomes.
• Partner with Information Technology teams to implement system improvements that support revenue cycle excellence.

Compliance & Quality Assurance

• Ensure operations comply with all regulatory guidelines, including HIPAA, Medicare/Medicaid, third-party payors, OSHA, and accrediting agencies.
• Maintain accurate documentation in billing systems and CRM per company standards.
• Travel as required for vendor meetings or departmental support.
• Other duties as assigned. (Major job functions)

Basic Qualifications

• Minimum 5 years of leadership experience in healthcare revenue cycle management, preferably in Durable Medical Equipment (DME) RCM.
• High School diploma required.
• Strong knowledge of governmental and commercial payors, billing codes (ICD, CPT, HCPCS), EOBs/ERNs, and payer compliance rules.
• Strong proficiency in Microsoft Excel and Power BI Apps.
• Excellent communication, leadership, and analytical skills.

Preferred Qualifications

• Bachelor's degree in Business Administration, Healthcare Administration, Finance, or related field.
• Experience leading enterprise revenue cycle initiatives and cross-functional business improvement projects.
• Experience with data analytics, business intelligence tools, and KPI-driven performance management.
• Knowledge of Lean, Six Sigma, or continuous improvement methodologies preferred.
  

  At Coloplast, we believe in recognizing and rewarding the contributions of our employees. Our total rewards package is designed to support your well-being, foster your professional growth, and ensure a healthy work-life balance. Here is some of what you can expect:

  • Health and Wellness:Comprehensive medical, dental, and vision insurance plans to keep you and your family healthy. Plus, access to company sponsored wellness programs and mental health resources, paid leave of absence for qualifying events and generous paid parental leave for both birthing and non-birthing parents.
  • Financial Security:A competitive 401(k) plan with company match that vest immediately, financial planning services to help you secure your future, and corporate discount programs for goods and services.
  • Work-Life Balance:Generous paid time off, flexible work hours, and flexible work arrangement options to help you balance your personal and professional life may be available.
  • Professional Development:Opportunities for continuous learning and career advancement through training programs, mentorship, and tuition reimbursement.
  • Recognition and Rewards:Recognition programs to celebrate achievements and contributions, including peer recognition, bonuses, awards, and special events.
  • Community and Culture:A supportive work environment where everyone feels valued and has a sense of belonging. Participate in team-building activities, volunteer opportunities, and company-sponsored events. Sustainability strategy that outlines our ambitions for how to run our company in a more sustainable way.
  • Competitive Compensation:The compensation range for this position is $95,898 - $143,847. Actual compensation is influenced by a variety of factors including but not limited to skills, experience, qualifications, and geographic location. Hired candidates may be eligible to receive additional compensation in the form of bonuses and/or incentives.

Comfort Medical provides an extensive selection of name brand catheter and ostomy supplies to thousands of customers nationwide. Our attention to detail, unmatched customer service, and dedication to helping our customers live happier, healthier lives are just a few of the many reasons we are one of the fastest growing catheter and ostomy supply companies in the nation!​

Comfort Medical employees are required to conduct business to the highest ethical and professional standards; comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies.

Comfort Medical is committed to a policy of Equal Employment Opportunity (EEO) which means we employ and promote individuals based on their merits, regardless of race, color, religion, sex, national origin, age, disability, veteran status, pregnancy, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status, status with regards to public assistance or any other protected classification.

62304