RCM Operations Lead

The RCM Operations Lead is responsible for managing the revenue cycle operations at a mission-driven digital health company that provides specialized mental health services for autistic and neurodivergent adults. The role involves overseeing billing processes, managing a support team, and ensuring efficient claim management to support the company's growth and clinical mission.

Location: United States

Responsibilities

• Own end-to-end billing operations across the full claims lifecycle, including insurance verification, prior authorization, claim submission, follow-up, denial/rejection resolution, and reporting.
• Lead and manage a team of 4+ offshore support staff, setting priorities, assigning work, reviewing output, and ensuring process consistency.
• Manage a high volume of billing questions and escalations from vendors and internal teams, investigating patient responsibility questions, handling escalations, and triaging high-priority items.
• Support ad-hoc RCM projects such as state launches, new payer setup, provider enrollment, and credentialing gaps.

Requirements

• 5+ years of hands-on RCM experience, with familiarity across the claims lifecycle including denials, rejections, adjustments, and resubmissions.
• Comfortable in Availity and standard provider portals.