National Home Health RCM & Credentialing Manager

DHVAJ•Clarksville, IN

12d

About The Position

MDOfficeManager is seeking an experienced manager with at least three years of hands-on experience in adult home health care, home health billing, healthcare credentialing, and nationwide licensing operations. The role oversees revenue cycle operations and coordinates credentialing, payer enrollment, and licensing across multiple U.S. states. It ensures compliance with applicable regulatory and payer requirements and implements strategies to improve reimbursement performance and operational efficiency. The position is based in Clarksville, Indiana, and is full-time, Monday through Friday from 8:00 AM to 5:00 PM. Remote work may be considered based on qualifications and business needs. Salary is to be determined based on experience and qualifications.

Requirements

At least three years of hands-on experience in adult home health care or home health operations.
At least three years of experience in home health billing and revenue cycle management.
At least three years of experience in healthcare credentialing, payer enrollment, and licensing coordination.
Demonstrated experience managing or coordinating nationwide healthcare licensing and credentialing requirements across multiple U.S. states.
Strong knowledge of Medicare, Medicaid, Medicare Advantage, and commercial insurance billing.
Experience with home health claims processing, denial management, reimbursement, and accounts receivable.
Working knowledge of provider credentialing, payer enrollment, license applications, and renewal processes.
Understanding of state-specific healthcare regulations and applicable home health licensing requirements.
Experience with electronic health records, medical billing platforms, and credentialing or licensing management systems.
Strong organizational, analytical, communication, and problem-solving skills.
Ability to manage multiple priorities and meet deadlines in a fast-paced healthcare environment.

Nice To Haves

Experience supporting adult home health agencies operating in multiple states.
Experience managing nationwide licensing and credentialing databases.
Familiarity with Medicare enrollment systems and commercial payer credentialing portals.
Previous experience supervising billing, credentialing, or revenue cycle teams.
Proficiency in Microsoft Excel and healthcare reporting tools.
Demonstrated success in improving billing accuracy, reducing claim denials, and streamlining administrative processes.

Responsibilities

Oversee the adult home health revenue cycle, including insurance verification, claims submission, payment posting, accounts receivable, collections, and reimbursement.
Manage billing operations for Medicare, Medicaid, Medicare Advantage, and commercial insurance plans.
Monitor revenue cycle performance and implement strategies to improve cash flow and reimbursement timelines.
Analyze billing discrepancies, identify revenue leakage, and implement corrective measures.
Track key performance indicators, including days in accounts receivable, denial rates, collection rates, and clean claim rates.
Ensure accurate and timely home health claims submission according to payer requirements.
Oversee denied, rejected, and underpaid claims and coordinate appeals and corrected claims.
Review billing documentation for compliance with reimbursement guidelines and work with clinical and administrative teams to resolve documentation issues.
Monitor billing requirements for Medicare, Medicaid, and commercial insurance applicable to home health services; identify denial trends and reduce billing errors.
Oversee provider and organization credentialing and payer enrollment activities nationwide, including applications, recredentialing, updates, renewals, and supporting documentation.
Coordinate enrollment with Medicare, Medicaid, and commercial payers, track application progress and deadlines, and resolve delays with payers, credentialing organizations, and regulatory agencies.
Maintain accurate credentialing records and standardized workflows for nationwide operations.
Coordinate applicable healthcare licensing and regulatory requirements across the United States, including applications, renewals, expirations, and supporting documentation.
Research and monitor state-specific licensing requirements, maintain centralized licensing tracking, and coordinate with state licensing boards and regulatory agencies.
Identify and communicate licensing and compliance gaps to leadership and ensure applicable requirements are addressed before operations or services begin in a jurisdiction.
Develop and implement standard operating procedures for billing, credentialing, payer enrollment, and licensing.
Collaborate with clinical, administrative, billing, and leadership teams to improve operational efficiency.
Monitor departmental performance and report on revenue cycle results, credentialing status, and licensing compliance.
Identify process improvements, implement corrective action plans, and maintain documentation for audits, payer reviews, and regulatory inquiries.
Train and support team members on billing, credentialing, licensing, and compliance procedures.