RCM Team Lead

Role & responsibilities

Thorough understanding of Revenue Cycle Management (A/R), with a strong focus on Denial Management, Prior Authorsition, Denials in the US healthcare industry.

Lead a team in managing and following up on outstanding medical claims by contacting insurance companies and patients.

Ensure adherence to SLAs and meet performance benchmarks for claim resolution and AR follow-up.

Train team members on domain knowledge and processes, while maintaining minimal team attrition.

Prepare for and actively participate in client meetings and communication.

Regularly update the AR inventory plan to ensure proactive claim follow-up.

Prevent revenue loss by addressing claims approaching the Timely Filing Limit.

Handle team disciplinary matters and ensure team compliance with quality parameters set by internal and external SLAs.

Implement process improvements, document results, and suggest corrective actions.

Coordinate closely with Department Heads (AR, Billing, Coding) to minimize Process gaps.

Highlight risks, backlogs, or process challenges to the VP of Operations.

Prepare and submit all MIS reports on time, and provide regular performance updates to top management.

Execute any additional tasks assigned by the VP of Operations as needed.

Minimum 5 to 8+ years of experience in US healthcare RCM as an Accounts Receivable Professional.

At least 1 year of experience as a Team Lead - RCM AR.

Proven expertise in handling AR processes in the US healthcare RCM industry.

Proficiency in Excel and PowerPoint, with the ability to manage reports and present data effectively.

Preferred candidate profile

Candidate Should be from Pharma Background .

Shift:

Fixed US Shift (6:30 PM to 3:30 AM)

Work from Office

Fixed Saturday and Sunday off

Please share your updated resume

 vijay.jadhav@sumasoft.net  /  WhatsApp at 8806000209