Director OF Business Operations

Director, Durable Medical Equipment Operations Location: Onsite – Dobbs Ferry, NY Full time Compensation: $150- $170K Reports to: President, Gramatan Supplies. "Experience with DME billing and Insurance is mandatory" Position Summary: The Director, DME Operations leads the end-to-end insurance and billing operations of the company's Durable Medical Equipment (DME) business, including order intake, order processing, documentation verification, and claims collection. This role is the operational hub connecting insurance payers, physicians, patients, caregivers, and clinics — ensuring every order is accurately captured, properly documented, and successfully billed within a regulated medical device environment. The Director balances patient/customer service, DME financial performance, and quality/regulatory obligations under applicable DME/CMS supplier standards. Responsible for managing and leading new scaling initiatives while ensuring continued smooth DME insurance, billing and order operations. Key Responsibilities Order Intake & Order Processing Own, manage, and lead the daily order intake process, ensuring all incoming orders from clinics, physicians, and patients are captured accurately and completely. Oversee order processing workflows from initial receipt through documentation verification, insurance authorization, and order finalization. Develop and deliver on operational KPIs related to order cycle time, order accuracy, documentation turnaround, and on-time processing. Develop and manage the department's operating budget related to billing and order operations functions. Oversee and manage the end-to-end insurance and billing process, including claims submission, follow-up, and collections for Medicare, Medicaid, and private insurance. Ensure all documentation (physician orders, prescriptions, proof of delivery, certificates of medical necessity, prior authorizations) fully supports timely and accurate payer claims. Monitor claim status, denials, and appeals, driving timely resolution and collection on outstanding claims. Monitor changes in payer policy and DME coverage requirements, adjusting billing and documentation workflows as needed. Verify and audit documentation for completeness and compliance prior to claims submission, minimizing denials and rework. Communication & Stakeholder Coordination Serve as the key point of coordination between insurance payers, physicians, clinics, patients, and caregivers throughout the order and billing lifecycle. Manage communication with patients and caregivers regarding order status, documentation needs, insurance coverage, and billing questions. Coordinate with physicians and clinics to obtain, clarify, or correct required documentation supporting orders and claims. Build and maintain strong working relationships with payer representatives to support timely authorization and claims resolution. Process Optimization & Team Training Continuously optimize order intake, documentation verification, and billing/claims workflows to improve accuracy, speed, and consistency. Design and roll out training programs so staff are hands‑on and proficient with new and evolving order and billing processes. Identify process gaps and bottlenecks in the order-to-claim lifecycle and implement corrective workflow improvements. Develop standard operating procedures (SOPs) for order intake, documentation verification, and claims collection. Hire, develop, train, and manage order intake and billing/insurance staff on current and evolving processes. Set performance goals, conduct reviews, and build a culture of accountability and continuous improvement. Cross‑Functional Collaboration Work with Sales, Customer Support, Regulatory Affairs, and Finance to align order and billing operations with business goals. Support new product/service launches by building out order intake, documentation, and billing processes. Report operational performance, claims status, and risks to executive leadership on a regular cadence. Qualifications Education & Experience Bachelor’s degree in business, Healthcare Administration, or a related field; MBA preferred (one of the fields is strongly required). 8+ years of progressive operations leadership experience, with at least 3–5 years in DME, home medical equipment (HME), or medical device billing/insurance‑related roles. Demonstrated experience managing order intake, documentation verification, and insurance billing/claims functions at scale. Experience operating within a regulated environment (CMS/DMEPOS, payer compliance) strongly preferred. Strong knowledge of DME reimbursement processes, payer requirements, and claims collection. Strong expertise and knowledge in managing Medicare/Medicaid DME insurance and billing. Proven ability to manage documentation verification and order processing workflows. Excellent communication skills for coordinating with insurance payers, physicians, patients, caregivers, and clinics. Proven people‑management and cross‑functional leadership skills. Strong knowledge and experience with process optimization and training. Strong analytical skills; comfortable using data/KPIs to drive decisions. Excellent communication and vendor/stakeholder management skills. #J-18808-Ljbffr