Lead, RCM Specialist

AdaptHealth•Wichita Falls, TX

About The Position

The Lead Revenue Cycle Management Specialist serves as a subject matter expert in insurance accounts receivable and provides leadership and guidance to domestic and global RCM team members. The role focuses on payer accounts receivable, complex escalations, trend analysis, problem-solving, mentoring, and operational improvement. The specialist works with leadership and cross-functional teams to improve billing accuracy, reduce rework and denials, and improve the patient financial experience. The role also develops and maintains standardized processes and provides reporting insights to support business decisions. The position requires compliance with HIPAA and other applicable regulatory standards when handling patient information. Compensation is based on experience, location, and role level.

Requirements

High school diploma required.
Three years of related work experience in administration, financial services, insurance, customer service, claims, billing, call-center work, or management required.
Experience leading or mentoring teams.
Ability to lead and operate in a fast-paced environment.
Ability to navigate multiple systems and understand data flow across platforms.
Strong analytical and problem-solving skills, with attention to detail.

Nice To Haves

Associate degree preferred.
Two years of work experience in HME, diabetic or home medical supplies, pharmacy, or a home health environment preferred but not required.
Experience working with payer policies, accounts receivable processes, and insurance billing preferred but not required.

Responsibilities

Provide day-to-day oversight, coaching, and mentorship to domestic and offshore RCM team members.
Serve as the subject matter expert for payer accounts receivable and handle complex escalations and insurance disputes.
Monitor team performance, identify skill gaps, and support training and development initiatives.
Analyze payer trends, denial patterns, and workflow gaps, and implement process improvements.
Collaborate with leadership and cross-functional teams to improve billing accuracy and reduce rework.
Develop and maintain standard operating procedures, job aids, and training materials to standardize processes.
Conduct in-depth analyses and provide reporting insights to support business decisions.
Support onboarding and ongoing education on systems, workflows, and payer guidelines.
Resolve escalated billing inquiries from patients and insurance providers accurately and with a focus on service excellence.
Partner cross-functionally to address account issues, reduce denials, and improve the patient financial experience.
Ensure compliance with HIPAA and all regulatory standards in handling patient information.
Perform other duties as assigned.

Benefits

Comprehensive medical, dental, and vision coverage, eligible the first of the month following hire.
401(k) with company match.
Paid time off plans, including six paid holidays.
Employee Stock Purchase Plan.
Paid parental bonding leave.
Short- and long-term disability insurance.
Life and AD&D insurance.
Flexible Spending Accounts and Health Savings Accounts.
CVS Minute Clinic and Teladoc access.
Spousal Advantage Reimbursement Plan.
Identity Theft Protection and Legal Plan.