Revenue Cycle Management (RCM) Healthcare Team Lead

Revenue Cycle Management (RCM) Healthcare Team Lead
$25-30 an hour
Birmingham, AL


Join a leading comprehensive medical practice management organization dedicated to providing highly experienced business leadership to physician practices. Our client is seeking a seasoned RCM Team Lead to manage and optimize medical claims processing, payment posting, and claims follow-up functions.



This pivotal role requires a deep understanding of the revenue cycle and proven leadership ability. This hire will be a key change agent, responsible for workflow optimization, team performance, and driving continuous improvement in claims processing.


Job Duties:

• Supervision: Assign and monitor the daily workload and process workflow for a designated team of RCM Analysts and Account Representatives.
• Performance Monitoring: Work closely with management to establish monthly goals and Key Performance Indicators (KPIs). Produce and share productivity reports weekly and provide consistent performance feedback to the team.
• Training & Quality: Provide continual education and on-the-job training to staff, addressing identified areas of opportunity. Conduct weekly random claim audits for each employee and review findings.
• Process Improvement: Act as a change agent by identifying opportunities to improve the claims processing workflow for the entire revenue cycle. Create compiled data reports and escalate issues to leadership for resolution.
• Claims Processing: Enter and ensure the completeness and accuracy of all information necessary for insurance claims (patient details, codes, modifiers, etc.).
• Submission: Validate, correct, and ensure timely electronic or paper submission of claims to clearinghouses and individual payers.
• Follow-Up & Resolution: Proactively follow up on unpaid or rejected claims, resolve complex claim issues, and prepare professional appeal letters with necessary supporting information when denials are not warranted.
• Collections: Provide necessary information to collection agencies for past due accounts.
• Trending: Compile data for trending analysis of errors and rejected claims to pinpoint root causes and systemic issues.
  

Qualifications:

• Experience: Minimum of five (5) years of experience in healthcare, insurance, or revenue cycle operations is required.
• Preferred Education: Bachelor's Degree.  
• System Experience (Highly Required): Proven, extensive experience (10 years is noted in the source material) with industry-standard practice management/HRIS software, specifically MDI and Nextgen.
• Essential Skills: Exceptional organizational skills, the ability to prioritize workload, and a high degree of proficiency and accuracy. Must be adaptable to a constantly changing work environment and maintain strict confidentiality.
• Travel: While the role is 100% in-office, some limited travel (estimated around 10%, not to exceed 25%) is required for meetings in remote offices (e.g., Tuscaloosa, Montgomery, Huntsville), likely on a quarterly basis.

 

At our clients’ request, only individuals with required experience will be considered.

Please note - if you have recently submitted your resume to a PangeaTwo posting, your qualifications will be considered for other open opportunities.

Your resume will never be submitted to a client without your prior knowledge and consent to do so.



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