Director of Billing and Reimbursement

VGM Group, Inc•Waterloo, IA

6h•Hybrid

About The Position

The Director of Billing and Reimbursement provides expert guidance to Home Medical Equipment (HME) providers on optimizing billing operations, ensuring regulatory compliance, and maximizing reimbursement across payer types. This role analyzes end-to-end revenue cycle performance, identifies process gaps, and implements strategies to improve claim accuracy, reduce denials, and accelerate cash flow. The Director stays current on Medicare, Medicaid, and commercial payer rules specific to DME/HME and partners closely with clients to train staff, enhance documentation practices, and establish scalable billing workflows. Through data-driven insights and industry expertise, this role helps HME organizations strengthen operational efficiency, financial performance, and long-term sustainability.

Requirements

Bachelor’s degree in business, Healthcare Administration, Finance, ora related field; Master’s degree preferred.
3-5 years of progressive experience in medical billing, reimbursement, or revenue cycle management, with at least 1-3 years in an influential leadership role preferred.
Deep knowledge of Medicare, Medicaid, and commercial payer regulations specific to DME/HME billing.
Proven experience improving claim accuracy, reducing denials, and increasing cash flow.
Strong understanding of end-to-end revenue cycle processes, including documentation, coding, claim submission, payment posting, and appeals.
Demonstrated ability to analyze billing data, interpret trends, and provide actionable recommendations.
Experience developing and implementing standardized billing workflows and scalable processes.
Proficiency with HME/DME billing software, revenue cycle platforms, and payer portals.
Excellent communication, client facing, and relationship building abilities.
Strong problem-solving skills with a continuous improvement mindset.
Ability to manage multiple client projects and deliver high quality results under deadlines.
Experience reading and interpreting legislation and regulations with the ability to summarize to internal and external customers
Capacity to write news publications/articles and social media posts
Solid working knowledge of Excel and relevant software such as MS-office: Word, PowerPoint etc.
Sound interpersonal, verbal, and written communication skills
Strong critical thinking skills and dedication to research.

Nice To Haves

Master’s degree preferred.
at least 1-3 years in an influential leadership role preferred.

Responsibilities

Monitor and research any new legislative/regulatory alerts at the state and federal level.
Provide expert guidance to HME providers on optimizing billing operations and reimbursement practices.
Ensure compliance with Medicare, Medicaid, and commercial payer requirements specific to DME/HME.
Analyze end-to-end revenue cycle performance to identify gaps and operational improvement opportunities.
Develop and implement strategies to improve claim accuracy, reduce denials, and accelerate cash flow.
Stay current on evolving payer rules, billing regulations, and industry best practices.
Partner closely with clients to train billing teams and enhance documentation quality.
Design scalable, efficient billing workflows to support organizational growth.
Use data-driven insights to improve operational efficiency and financial performance.
Support HME organizations in strengthening long-term sustainability through effective reimbursement strategies.
Frequent interaction with VGM Government Relations members will occur.
Monitor and respond to Discussion Board and other inquiries as appropriate.
Assist in the development of website content for members to educate themselves on reimbursement inquiries.
Continuously evaluate and update technology driven knowledge assets to reflect current policies, regulatory changes, and member needs, ensuring high quality automated engagement and self-service support.
Provide content for VGM newsletters and updates provided to members
Answer internal billing reimbursement questions, via telephone or in person.
Produce content for policy updates and industry articles.
Posting/monitoring social media for opportunities.
Help prepare formal presentations and participate in formal presentations.
Perform other routine administrative tasks as needed.