DME / Healthcare Back Office Operations Manager

iscale solutionsMakati Central Post Office, Philippinesfull timeSenior
Active

Job description

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 iScale’s healthcare services.Key ResponsibilitiesLead 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.RequirementsQualifications3–5+ 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 CompetenciesDME/HME Operations & Revenue Cycle ManagementU.S. Healthcare & Insurance ProcessesOperations & People LeadershipClient & Stakeholder ManagementPerformance and KPI ManagementQuality & Process ImprovementWorkforce & Capacity ManagementCoaching & Talent DevelopmentDocumentation & ComplianceData Analysis & Operational ReportingProblem Solving & Decision MakingAccountability & Service ExcellenceMinimum 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. BenefitsHMo on Day1, Government Benefits