As the Senior Revenue Cycle Manager, you will be responsible for leading the Medicare and File Resolution teams for the Respiratory Health home care portfolio whose functions include, medical documentation collection, Medicare Clinical Review, Medicare Appeals, Medicare and Managed Medicare Accounts Receivable, Medicare Audits and Change of Insurance. Oversee a staff including leaders (exempt) and individual contributors (non-exempt). Establish and manage team to execute departmental standard operating procedures, standard of work, and service level agreements. Monitor daily, weekly, monthly, and quarterly KPI’s/metrics and productivity and adjust as necessary to meet business goals and objectives. Monitor CMS Rules and Regulations and work with business leaders to implement changes. Monitor Medicare Audits and analysis results for trends. Manage escalation process to identify trends and aid in driving resolution to process, team member, or payer challenges for escalated issues. Collaborate cross-functionally to lead denial management program to identify opportunities to improve payer outcomes and maximize reimbursement coverage for patients. Ensure team’s understanding and adherence to all polices for Baxter and third-party payers to achieve the highest standards of quality and compliance. Collaborate with cross-functional stakeholders including sales team and other internal teams to drive continuous improvement and meet business goals and objectives. Identify and implement technology enhancements to improve department efficiencies. Partner with Business Improvement to design, validate, and maintain metric and reporting tools and dashboards. Lead the team in a superior internal and external customer experience by leveraging ability to discuss Medicare policies, coverage criteria, benefit details, potential costs, or any other pertinent product information. Recruit, hire, and train staff including on-going performance evaluation, feedback, and accountability to established standards. Coach, mentor, and develop staff to develop and retain the highest level of talent. Maintain daily, positive communication with team members, sales organization, and other departments to foster a collaborative and inclusive culture. Actively seek additional industry experience and knowledge to stay up to date with the ever-evolving DME landscape to gain expertise.

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