Revenue Cycle Management Team Lead

Position Overview:

As the Revenue Cycle Management (RCM) Team Lead, you will play a crucial role in overseeing and optimizing the revenue cycle process in your assigned work stream. You will be responsible for leading a team of revenue cycle specialists, ensuring the timely and accurate processing of functions in your work stream, maximizing revenue collection, and maintaining compliance with regulatory requirements. The ideal candidate will have a strong background in revenue cycle management, possess excellent critical thinking, problem solving and communication skills. An RCM Team Lead has good leadership skills, a professional demeanor and a passion for driving operational excellence.  

Key Responsibilities:

• Provide leadership and guidance to a team of revenue cycle specialists, including both stateside & global partner team members. A Team Lead provides training, (including authorship of written directives) mentoring, and performance management.
• Foster a collaborative and high-performance culture within the team, promoting teamwork and accountability.
• Set clear goals and objectives for the team, monitoring progress and implementing strategies to achieve targets. 
• Oversee the end-to-end revenue cycle process in your assigned workstream. 
• Identify opportunities for process improvement and implement best practices to streamline workflows and maximize revenue collection. 
• Conduct regular audits and reviews to ensure the accuracy and completeness of billing data and compliance with billing guidelines and regulations. 
• Manage the core processes within your assigned workstream, including RCM functions such as registrations, authorizations, referrals, coding and charge capture, claim submission, payment and adjustment posting, follow-up, resolution of denials and appeals, patient balance billing, refund and credit bureau processing. 
• Monitor key performance indicators related to your work stream including first pass claims acceptance, denials, aging, liquidation, days in AR (DSO), outstanding accounts receivable and credit liabilities. 
• Work closely with payers, vendors and patients to resolve outstanding claims items in a timely manner. 
• Develop strategies to minimize claim rejections and denials, optimizing first-pass resolution rates. 
• Analyze revenue cycle metrics and key performance indicators (KPIs) related to your work stream to identify trends and areas for improvement. 
• Prepare regular reports and presentations for management, providing insights into revenue cycle performance and financial outcomes. 
• Collaborate with finance and accounting teams to reconcile revenue cycle data and ensure accurate financial reporting. 
• Ensure compliance with billing and coding regulations, HIPAA guidelines, and other relevant healthcare laws and regulations.
• Implement internal controls and audits to mitigate compliance risks and maintain data integrity. 

• Bachelor's degree in healthcare administration, business, finance, or related field preferred.  
• Minimum of 5 years of experience in revenue cycle management, with at least 1 year in a leadership role. 
• Certification in healthcare revenue cycle management (e.g., HFMA Certified Revenue Cycle Representative, Certified Professional Coder) is preferred 
• Demonstrated strong knowledge of healthcare billing and reimbursement processes, including Medicare, Medicaid, and commercial insurance. 
• Proficiency in using revenue cycle management software and electronic health records (EHR) systems. 
• Excellent analytical skills with the ability to interpret data and trends, identify root causes, and develop effective solutions. 
• Strong communication and interpersonal skills, with the ability to collaborate effectively across departments and communicate complex information to diverse audiences. 
• Detail-oriented and highly organized, with the ability to manage multiple priorities and deadlines in a fast-paced environment.