Team Lead, RCM Operations

The Role

The RCM Operations Team Lead plays a pivotal role in supporting the Sr. Manager in overseeing the daily operations of the revenue cycle management (RCM) teams. Tasked with optimizing all aspects of the revenue cycle, this position focuses on maximizing client revenue retention and enhancing service gains. Additionally, the RCM Operations Team Lead takes a leadership role in training and educating both new and existing employees on the utilization of practice management systems, ensuring proficiency and efficiency across the organization.

Key Responsibilities

Client Expertise & Issue Prevention

• Act as the primary subject matter expert for assigned client accounts, with expert-level familiarity of client workflows, payer-specific challenges, and account nuances.
• Conduct thorough root cause analysis of first-pass rejected claims, denied claims, and discrepancies in reporting tools and clearinghouse submissions.
• Proactively identify accounts receivable (AR) and billing trends, payment anomalies, and potential issues before they escalate.
• Serve as the first line of escalation for team members encountering barriers in resolving accounts or workflow issues.

Work Assignment, Validation & Oversight

• Assign weekly workloads to team members based on claim volume, account needs, and strategic priorities.
• Use reporting tools, dashboards, and submission logs to validate completion and accuracy of assigned work.
• Proactively flag red flags in performance metrics or account behavior and take ownership of resolution or follow-up.
• Ensure all end-of-month processes are completed accurately and ready for reporting to clients.
• Support of functional role including but not limited to Accounts Receivable, Billing and Payment Posting

Training, Coaching & Team Development

• Facilitate onboarding and training of new hires across multiple software platforms and web-based systems.
• Provide hands-on support to team members in claim preparation, submission, and AR follow-up.
• Conduct weekly 1:1s, team syncs, and development check-ins to coach, mentor, and foster professional growth.
• Build a culture of accountability, continuous improvement, and high performance.

Reporting, Monitoring & Other Duties

• Generate and submit monthly reports on patient balances due and refund balances to CRCs.
• Leverage AR Aging Reports, Denial/Rejection Dashboards, EOB Tracking Logs, Claim Submission Logs, and Productivity Reports to guide oversight.
• Ensure accurate, timely reporting that supports financial analysis and decision-making.
• Research and recommend adjustments/write-offs with supporting analysis for leadership approval.
• Perform other duties or projects as assigned by leadership.

Minimum Requirements

• A minimum of 2 years of hands-on experience with a proven track record in effectively managing the day-to-day functions of a billing and collections team, including reviewing, coding, and collecting professional services provided. Demonstrated proficiency in navigating the complexities of revenue cycle management within the healthcare industry is essential.
• A proactive change agent capable of driving organizational transformation and guiding teams through change management initiatives to propel the organization towards future success. Possesses strong leadership qualities and strategic vision to implement innovative solutions and adapt to evolving industry trends and regulations.
• Exceptional supervisory competencies, including demonstrated proficiency in leadership and team development, coaching, mentoring, and situational assessment skills. Proven track record of fostering a culture of continuous improvement and building high-performing teams that deliver exceptional results
• Proficient in utilizing a variety of software applications essential for revenue cycle management, including Google for Business, Microsoft Excel, Word, and other relevant tools and platforms. Familiarity with clearinghouses and other Software as a Service (SaaS) products used in the healthcare billing and collections process is highly desirable.

HIPAA Requirements

All associates are required to comply with the Health Insurance Portability and Accountability Act (HIPAA) regulations regarding the protection of patient health information. This includes adherence to the organization's Notice of Privacy Practices and HIPAA Privacy Policies and Procedures.

The specific statements provided in this job description are not exhaustive and may be subject to change based on evolving business needs. Associates may be required to perform additional duties as assigned.

Here at Prompt, we are committed to fostering a fair and respectful work environment. As part of this commitment, it is our policy not to hire individuals from Prompt Customers unless they have obtained their current employer's explicit consent. We believe in upholding strong professional relationships and respecting the agreements and commitments our customers have with their employees.

We appreciate your understanding and cooperation regarding this policy. If you have any questions or concerns, please don't hesitate to reach out to our HR department.

Prompt Therapy Solutions, Inc is an equal opportunity employer, indiscriminate of race, color, religion, ethnicity, ancestry, national origin, sex, gender, gender identity, sexual orientation, age, marital status, veteran status, disability, medical condition, or any other protected characteristic. We celebrate diversity and are committed to creating an inclusive environment for all employees.