Revenue Cycle Team Leader - Hybrid Remote

Revenue Cycle Team Leader - Hybrid Remote Opportunity

Position Overview:

Under the direction of the Supervisor/Manager/Director, the Revenue Cycle Team Leader provides advanced expertise, daily workflow coordination, quality oversight, and operational support for hospital and/or clinic Patient Financial Services. The role serves as the subject matter expert for complex billing, payer requirements, claim resolution, accounts receivable, collections, and denials, and guides staff so claims are submitted accurately, timely, and compliantly and accounts are resolved for appropriate reimbursement. The Team Leader partners with Patient Access, Health Information Management, Coding, clinical departments, payers, patients, and other stakeholders to reduce denials and rework, improve clean-claim performance, manage accounts receivable, and support organizational revenue cycle goals. This position has a hybrid remote schedule, where employees are expected to come into the office as needed during a given time for department needs. 

Supervisory Responsibilities:

• Provides functional leadership, guidance, training, and workflow coordination to revenue cycle staff as assigned.
• Serves as a resource and escalation point for complex billing, collections, denial, accounts receivable, and payer-related issues.

Key Responsibilities:

• Provides functional leadership, guidance, training, and workflow coordination to assigned revenue cycle staff, and serves as the escalation point for complex billing, denial, accounts receivable, and payer issues.
• Coordinates daily workflows and prioritizes work by claim volume, payer requirements, aging, financial impact, deadlines, and collection opportunity.
• Performs advanced review and resolution of billing edits, rejections, returned claims, discrepancies, payer requests, denials, underpayments, and other barriers to timely submission or payment, including Medicare-specific issues such as DDE, claim overlaps, RTPs, rebills, and corrected claims.
• Actively works assigned accounts receivable, including aged, high-dollar, denied, rejected, unpaid, and underpaid accounts, and conducts payer follow-up and collection activity consistent with payer rules and organizational policy.
• Identifies recurring rejection and denial trends, addresses root causes with other departments, and coordinates rebills, corrected claims, appeals, and account corrections through to completion.
• Reviews claim status, remittance, payment activity, and reports to identify discrepancies, maximize reimbursement, and monitor metrics such as clean claim rate, denial and rejection rates, A/R aging, days in A/R, unbilled accounts, and collection performance.
• Supports Medicare, Medicaid, commercial, and other external audits by researching accounts, gathering documentation, and responding within deadlines.
• Participates in policy, procedure, and performance-improvement work; assists with system implementations, upgrades, and testing; and communicates significant payer, system, denial, and A/R issues to leadership.
• Provides coverage for billing, follow-up, denial, and collection functions as needed, maintains accurate documentation, and complies with HIPAA and confidentiality requirements.

McKenzie Health reserves the right to assign, reassign, or eliminate duties and responsibilities as necessary. The description of critical job features is not exhaustive and may change as deemed appropriate.

Physical Requirements:

• Primarily remote/office-based environment with periods of high workload and time-sensitive activity.
• Sitting for extensive periods of time.
• Ability to work at a computer for extended periods.
• Ability to lift, move, push or pull a minimum of 15 pounds.
• May be required to work beyond normal working hours, weekends, or holidays based on departmental needs.

Required Skills and Abilities:

• Strong analytical and problem-solving skills, with the ability to research complex billing, denial, and payment issues, identify root causes, and apply payer and regulatory requirements correctly.
• Excellent communication and interpersonal skills, and the ability to coach staff, explain complex account issues clearly, and work effectively with internal departments, payers, and patients.
• Strong organization and prioritization, with the ability to manage competing deadlines, aged and high-value accounts, and collection opportunities independently and with sound judgment on escalation.
• Proficient in healthcare billing platforms, clearinghouses, payer portals, accounts receivable systems, and Microsoft Office; able to use metrics to spot trends and adapt to system, payer, and regulatory changes.
• High attention to detail, commitment to accurate and compliant billing, and strict confidentiality under HIPAA.
• Must pass a background check and drug screening.

Education and Experience:

• High school diploma or GED required; associate’s or bachelor’s degree in Healthcare Administration, Business, Finance, Health Information Management, or a related field preferred.
• Five years of progressive healthcare revenue cycle, hospital billing, Patient Financial Services, accounts receivable, or collections experience preferred, with advanced demonstrated experience in Medicare, Medicaid, and commercial billing and reimbursement, including complex claims, edits, rejections, denials, rebills, appeals, and unpaid or underpaid accounts.
• Experience with Medicare billing systems, payer portals, claim editing systems, accounts receivable systems, and/or EHR billing platforms required; Epic preferred. Experience supporting audits, appeals, staff training or workflow guidance, and revenue cycle performance improvement preferred. CPB, CRCR, or equivalent certification preferred.
• Strong analytical, problem-solving, organizational, and communication skills, with the ability to interpret payer and regulatory requirements, prioritize competing deadlines, coach staff, and work independently with sound judgment on escalation.
• Proficient in healthcare billing platforms, clearinghouses, payer portals, and Microsoft Office; able to adapt to system, payer, and regulatory changes. Must pass a background check and drug screening and maintain strict confidentiality under HIPAA.

Licenses and Certifications:

• Certified Professional Biller (CPB), Certified Revenue Cycle Representative (CRCR), or other applicable revenue cycle certification preferred.

McKenzie Health is an equal opportunity employer and does not discriminate against any applicant or employee on the basis of age, color, sex, disability, national origin, race, religion, or veteran status.