RCM Team Lead

Key Responsibilities:

1.Leadership & Team Management:

• Supervise and guide a team of RCM specialists to ensure smooth workflow and operational efficiency.
• Set performance benchmarks, monitor key metrics, and provide coaching and training to enhance team productivity.
• Conduct regular team meetings to address challenges, discuss process improvements, and ensure adherence to policies.

2.Revenue Cycle Operations & Optimization:

• Oversee claim submissions, payment posting, denial management, and accounts receivable follow-ups.
• Ensure timely resolution of claim denials and rejections to maximize reimbursement.
• Implement best practices to enhance revenue collection and minimize outstanding balances.
• Collaborate with coding and billing teams to ensure accurate claim submissions.

3.Denial Management & Accounts Receivable (AR) Resolution:

• Identify and analyse claim denial trends, working with internal teams to reduce future occurrences.
• Develop and implement effective appeal strategies for denied claims.
• Monitor aging reports and work on strategies to reduce AR days and improve cash flow.

4.Compliance & Regulatory Adherence:

• Ensure compliance with healthcare regulations, payer policies, and industry standards (HIPAA, Medicare, Medicaid, etc.).
• Stay updated on changes in reimbursement policies, coding updates, and regulatory requirements.
• Implement internal audit processes to maintain billing accuracy and compliance.

5. Reporting & Process Improvement:

• Generate and analyse revenue cycle reports to track performance, identify bottlenecks, and suggest improvements.
• Provide insights and recommendations to senior management for optimizing RCM processes.
• Develop strategies to enhance efficiency, reduce denials, and improve overall revenue cycle outcomes.
• Serve as the primary point of contact for clients, ensuring professional and courteous communication.
• Maintain strong relationships with clients by providing clear, accurate, and helpful information

Required Skills and Qualifications:

• Education: Diploma or Bachelors degree in related field (preferred).
• Experience: Minimum 3-5 years of experience in revenue cycle, healthcare finance or medical billing.
• Experience leading a team or managing revenue cycle processes.

Analytical Skills:

• Strong problem-solving and analytical abilities.
• Strong understanding of medical coding (CPT, ICD-10, HCPCS) and insurance regulations.
• Ability to work collaboratively with cross-functional teams and payers.

Communication Skills

• Excellent written and verbal communication.
• Other Skills:Strong organizational and multitasking abilities

gauri.matte@sumasoft.net