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PANGEATWO · 6 hours ago

Revenue Cycle Management (RCM) Healthcare Team Lead

Birmingham, AL

Full-time

Onsite

Senior Level

$25/hr - $30/hr

5+ years exp

PANGEATWO is a leading comprehensive medical practice management organization dedicated to providing experienced business leadership to physician practices. They are seeking a seasoned RCM Team Lead to manage and optimize medical claims processing, payment posting, and claims follow-up functions, driving continuous improvement and team performance.

ConsultingHuman ResourcesInformation TechnologySmall and Medium BusinessesStaffing Agency

Responsibilities

Supervision: Assign and monitor the daily workload and process workflow for a designated team of RCM Analysts and Account Representatives

Performance Monitoring: Work closely with management to establish monthly goals and Key Performance Indicators (KPIs). Produce and share productivity reports weekly and provide consistent performance feedback to the team

Training & Quality: Provide continual education and on-the-job training to staff, addressing identified areas of opportunity. Conduct weekly random claim audits for each employee and review findings

Process Improvement: Act as a change agent by identifying opportunities to improve the claims processing workflow for the entire revenue cycle. Create compiled data reports and escalate issues to leadership for resolution

Claims Processing: Enter and ensure the completeness and accuracy of all information necessary for insurance claims (patient details, codes, modifiers, etc.)

Submission: Validate, correct, and ensure timely electronic or paper submission of claims to clearinghouses and individual payers

Follow-Up & Resolution: Proactively follow up on unpaid or rejected claims, resolve complex claim issues, and prepare professional appeal letters with necessary supporting information when denials are not warranted

Collections: Provide necessary information to collection agencies for past due accounts

Trending: Compile data for trending analysis of errors and rejected claims to pinpoint root causes and systemic issues

Qualification

Revenue Cycle ManagementClaims ProcessingMDINextgenHealthcare ExperienceOrganizational SkillsAdaptabilityConfidentiality

Required

Minimum of five (5) years of experience in healthcare, insurance, or revenue cycle operations is required

Proven, extensive experience (10+ years is noted in the source material) with industry-standard practice management/HRIS software, specifically MDI and Nextgen

Exceptional organizational skills, the ability to prioritize workload, and a high degree of proficiency and accuracy

Must be adaptable to a constantly changing work environment and maintain strict confidentiality

While the role is 100% in-office, some limited travel (estimated around 10%, not to exceed 25%) is required for meetings in remote offices (e.g., Tuscaloosa, Montgomery, Huntsville), likely on a quarterly basis