DME Healthcare Back Office Operations Manager
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Job Summary
At iScale Solutions we are expanding our healthcare capabilities by building dedicated back-office teams supporting Durable Medical Equipment (DME) and U.S. healthcare providers.
We are looking for an experienced DME / Healthcare Back Office Operations Manager to lead and develop our growing healthcare operations. The role will oversee service delivery across DME functions such as patient intake insurance verification prior authorization order processing documentation medical billing claims and Revenue Cycle Management (RCM).
The ideal candidate combines strong DME/U.S. healthcare operational knowledge with people leadership client management process improvement and performance management experience. This role will also play an important part in establishing operational standards developing teams and supporting the continued growth of iScales healthcare services.
Lead day-to-day DME and healthcare back-office operations ensuring service quality productivity accuracy and timely delivery.
Oversee workflows covering patient intake order processing eligibility and benefits verification prior authorization documentation billing AR claims denials and appeals.
Ensure teams follow client requirements payer guidelines documentation standards and established healthcare processes.
Manage team performance against KPIs SLAs quality productivity attendance and capacity targets.
Coach Team Leaders and Specialists and establish performance improvement and development plans.
Serve as a primary operational point of contact for clients and internal stakeholders.
Analyze operational trends identify risks and bottlenecks and implement process improvements.
Support recruitment training onboarding workforce planning and development of DME talent.
Develop and maintain SOPs workflows quality controls reporting and operational governance.
Partner with leadership on new client implementations transitions and expansion of healthcare services.
35 years of U.S. healthcare operations experience preferably within DME/HME medical billing or Revenue Cycle Management.
At least 2 years of leadership experience managing healthcare operations Team Leaders or specialized healthcare teams.
Strong understanding of DME workflows Medicare Medicaid commercial insurance eligibility verification prior authorization claims AR and denials.
Familiarity with HCPCS codes modifiers SWO/CMN documentation medical necessity and payer requirements is highly preferred.
Experience managing KPIs SLAs quality productivity staffing and client performance reporting.
Strong client-facing communication analytical problem-solving and decision-making skills.
Experience with DME/healthcare platforms such as Brightree Parachute Health NikoHealth Availity Office Ally EMR/EHR systems or similar platforms is an advantage.
Strong understanding of patient-data confidentiality and healthcare information-handling requirements.
DME/HME Operations & Revenue Cycle Management
U.S. Healthcare & Insurance Processes
Operations & People Leadership
Client & Stakeholder Management
Performance and KPI Management
Quality & Process Improvement
Workforce & Capacity Management
Coaching & Talent Development
Documentation & Compliance
Data Analysis & Operational Reporting
Problem Solving & Decision Making
Accountability & Service Excellence
Minimum 5 years of experience in U.S. healthcare operations with at least 3 years of relevant DME/HME medical billing or RCM experience and 2 years in a leadership or operations management capacity.
Required Skills:
Qualifications 35 years of U.S. healthcare operations experience preferably within DME/HME medical billing or Revenue Cycle Management. At least 2 years of leadership experience managing healthcare operations Team Leaders or specialized healthcare teams. Strong understanding of DME workflows Medicare Medicaid commercial insurance eligibility verification prior authorization claims AR and denials. Familiarity with HCPCS codes modifiers SWO/CMN documentation medical necessity and payer requirements is highly preferred. Experience managing KPIs SLAs quality productivity staffing and client performance reporting. Strong client-facing communication analytical problem-solving and decision-making skills. Experience with DME/healthcare platforms such as Brightree Parachute Health NikoHealth Availity Office Ally EMR/EHR systems or similar platforms is an advantage. Strong understanding of patient-data confidentiality and healthcare information-handling requirements. Core Competencies DME/HME Operations & Revenue Cycle Management U.S. Healthcare & Insurance Processes Operations & People Leadership Client & Stakeholder Management Performance and KPI Management Quality & Process Improvement Workforce & Capacity Management Coaching & Talent Development Documentation & Compliance Data Analysis & Operational Reporting Problem Solving & Decision Making Accountability & Service Excellence Minimum 5 years of experience in U.S. healthcare operations with at least 3 years of relevant DME/HME medical billing or RCM experience and 2 years in a leadership or operations management capacity.
Required Education:
Any medical course
