Team Lead, RCM Operations

Key Responsibilities

• Act as primary subject matter expert for assigned client accounts, with expert-level familiarity of workflows, payer challenges, and nuances.
• Conduct root cause analysis of first-pass rejected claims, denied claims, and discrepancies in reporting tools and clearinghouse submissions.
• Proactively identify AR and billing trends, payment anomalies, and potential issues.
• Serve as first line of escalation for team members on account or workflow barriers.
• Assign weekly workloads based on claim volume, account needs, and priorities.
• Validate completion and accuracy of work using reporting tools, dashboards, and logs.
• Flag performance metric red flags and own resolution.
• Ensure accurate completion of all end-of-month processes.
• Support functional roles in Accounts Receivable, Billing, and Payment Posting.
• Facilitate onboarding and training of new hires on multiple software platforms and web-based systems.
• Provide hands-on support in claim preparation, submission, and AR follow-up.
• Conduct weekly 1:1s, team syncs, and development check-ins for coaching and mentoring.
• Build culture of accountability, continuous improvement, and high performance.
• Generate and submit monthly reports on patient balances due and refund balances.
• Leverage AR Aging Reports, Denial/Rejection Dashboards, EOB Tracking Logs, Claim Submission Logs, and Productivity Reports.
• Research and recommend adjustments/write-offs with analysis for leadership approval.
• Perform other duties or projects as assigned.

Minimum Requirements

• 2+ years hands-on experience managing day-to-day functions of a billing and collections team, including reviewing, coding, and collecting for professional services.
• Demonstrated proficiency in revenue cycle management in healthcare.
• Proactive change agent with ability to drive transformation and guide teams through change management.
• Strong leadership qualities, strategic vision, and ability to implement innovative solutions.
• Exceptional supervisory skills in leadership, team development, coaching, mentoring, and situational assessment.
• Proven track record fostering continuous improvement and building high-performing teams.
• Proficient in Google for Business, Microsoft Excel, Word, and other RCM tools.
• Familiarity with clearinghouses and SaaS products in healthcare billing/collections (highly desirable).

Nice-to-Haves

• Familiarity with clearinghouses and SaaS products used in healthcare billing and collections.