RCM Team Lead

Job Summary

Ensures the accurate and timely execution of accounts receivable processes within the Revenue Cycle Services team with the goal of maximizing accounts receivable collections for Veradigms clients. Executes accounts receivable processes and serves as a subject matter expert for the team to resolve complex accounts receivable issues. Maintains accurate and up-to-date billing records, follows up on outstanding medical billing claims and patient payments, and resolves billing issues. Works closely with other team members to ensure that payments are collected in a timely manner and that financial records are kept in strict compliance with company and client policies and regulations. Assists management in evaluating team members performance and identifying training needs.

Essential Functions/Major Job Responsibilities

• Promptly responds to internal and external client inquiries, interactions, and requests for information.
• Acts as the initial point of contact for team members regarding technical work questions, processes, and procedures and provides guidance on work matters.
• Escalates issues to RCS Management related to clients and staff.
• Monitors and manages accounts receivable (AR) to ensure timely claim resolution
• Organizes, identifies and improves workflow with team members and management through daily and weekly productivity reports. Escalates challenges, concerns, and needs for assistance to RCS Management.
• Maintains the ability to perform the duties of the Payment Entry Specialist, Charge Entry Specialist, and/or AR Specialist.
• Serves as the teams subject matter expert regarding the claims process, complex claims, AR issues, and claims software.
• Monitors team productivity and generates reports on team performance. Assists management in identifying performance issues.
• Trains new hires and answers questions from less experienced associates.
• Assists with implementing new clients and offboarding client terminations.
• Reconciles account discrepancies by investigating documentation, issuing credit memos, and processing adjustments.
• Maintains accurate financial records and prepares reports on the status of the AR.
• Monitors and reconciles claims, including held vouchers, unbilled vouchers, denial trends, patient balance report, credits, and refunds.
• Effectively handles complex payer denials.
• Processes and pays secondary claims.
• Communicates with clients and medical insurance carriers to resolve billing queries.
• Assists with financial audits by providing necessary documentation and explanations for AR processes.
• Implements process improvements to enhance the efficiency of the AR cycle.

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