Team Lead, Enterprise RCM Operations

Prompt

3d•$70,000 - $85,000•Hybrid

About The Position

The Enterprise RCM Operations Team Lead serves as the operational lead and subject matter expert for assigned enterprise-level client accounts, functioning as an extension of the client’s revenue cycle team. This role is responsible for overseeing accounts receivable performance, identifying operational improvement opportunities, supporting enterprise client workflows, and driving successful revenue cycle outcomes through proactive partnership and operational leadership. The Enterprise RCM Operations Team Lead partners closely with Client Success Managers, internal operational teams, and client stakeholders to ensure efficient revenue cycle operations, issue resolution, workflow optimization, and high-quality client support. This role combines operational oversight, team leadership, root cause analysis, and customer-facing collaboration to support enterprise client success.

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.
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.

Nice To Haves

Familiarity with clearinghouses and other Software as a Service (SaaS) products used in the healthcare billing and collections process is highly desirable.

Responsibilities

Serve as the primary operational point of contact for assigned enterprise client accounts related to Accounts Receivable, Billing, Payment Posting, and revenue cycle workflows.
Develop and maintain expert-level knowledge of assigned client workflows, payer behavior, operational processes, provider nuances, and account-specific requirements.
Function as an extension of the client’s revenue cycle team by building strong working relationships and maintaining a deep understanding of client operations and workflows.
Partner closely with Client Success Managers to support overall client health, operational alignment, escalations, and performance initiatives.
Collaborate directly with enterprise clients to identify workflow inefficiencies, operational gaps, denial trends, and revenue cycle improvement opportunities.
Provide operational guidance and revenue cycle best practice recommendations to support client success and workflow optimization.
Participate in client meetings, operational reviews, and escalation discussions related to AR performance and operational initiatives.
Conduct detailed root cause analysis of denied claims, rejected claims, underpayments, payment variances, and workflow breakdowns across payer systems, clearinghouses, and internal platforms.
Identify systemic operational issues impacting reimbursement performance and partner with internal teams and clients to implement corrective actions and sustainable process improvements.
Proactively monitor Accounts Receivable (AR), denial trends, aging performance, and payment anomalies to prevent escalation and minimize revenue cycle disruption.
Serve as the first line of escalation for team members encountering barriers in claim resolution, payer issues, or workflow challenges.
Translate operational findings and account trends into actionable recommendations for both internal teams and enterprise clients.
Assign and prioritize weekly workloads based on enterprise client needs, claim volumes, account priorities, and service expectations.
Oversee daily operational performance across AR, Billing, Payment Posting, and related revenue cycle functions.
Utilize dashboards, reporting tools, clearinghouse data, and productivity metrics to validate work quality, monitor performance, and ensure completion of assigned tasks.
Identify operational risks, workflow bottlenecks, and performance concerns while driving accountability and resolution efforts.
Ensure all end-of-month processes, reconciliations, and reporting deliverables are completed accurately and within required timelines.
Support operational consistency and adherence to internal workflows, payer requirements, and client expectations.
Facilitate onboarding and ongoing training for team members across enterprise client workflows, payer requirements, systems, and operational processes.
Provide hands-on support and coaching related to claim preparation, submission quality, denial resolution, payment posting, and AR follow-up.
Conduct regular 1:1 meetings, team syncs, and development discussions focused on performance improvement, accountability, and professional growth.
Mentor team members on effective operational problem-solving, client communication, and revenue cycle best practices.
Foster a culture of collaboration, continuous improvement, operational ownership, and high-quality client support.
Generate, review, and distribute monthly reporting related to AR performance, patient balances, refund balances, denial trends, payment variances, and operational KPIs.
Leverage AR Aging Reports, Denial/Rejection Dashboards, EOB Tracking Logs, Claim Submission Logs, Productivity Reports, and client-specific analytics to guide operational oversight and decision-making.
Ensure timely and accurate reporting that supports financial analysis, operational planning, and client discussions.
Research and recommend account adjustments, write-offs, workflow enhancements, and operational improvements with supporting analysis for leadership review.
Support enterprise client audits, operational reviews, escalations, and strategic initiatives as assigned.
Perform additional duties and special projects as assigned by leadership.