Job Summary
The Team Leader – RCM oversees daily operations of the hospital billing team, including Accounts Receivable (AR) and Denials Management. This role ensures compliance with payer guidelines (e.g., Centers for Medicare & Medicaid Services (CMS)), HIPAA regulations (HIPAA)), and hospital policies while driving key performance indicators (KPIs) such as Days in AR, Cash Collections, Denial Rate, and Clean Claim Rate.
Qualifications
5+ years of hospital RCM experience
2+ years of supervisory experience
Strong knowledge of UB-04 claims, Medicare/Medicaid billing
Experience with hospital billing systems (ECW and Meditech)
Strong analytical and leadership skills
Key Responsibilities
Supervise AR Specialists and Denial Management staff.
Allocate workloads based on payer mix (e.g., Aetna, Cigna, UnitedHealthcare, Medicare, Medicaid).
Monitor daily productivity, quality, and aging reports.
Conduct team huddles to review performance metrics and priority accounts.
Track and manage:
Days in AR
AR > 90/120 days
First Pass Resolution Rate (FPRR)
Denial Rate
Net Collection Rate
Identify revenue leakage and implement corrective action plans.
Handle complex escalations from payers and patients.
Coordinate with corresponding teams for claim corrections.
Manage high-dollar and aged accounts personally when needed.
Ensure adherence to CMS billing guidelines and payer-specific rules.
Conduct internal quality audits.
Provide ongoing training on billing updates, payer policies, and system changes.
Mentor team members and develop performance improvement plans.
How to Apply
Interested candidates can send your portfolio with updated CV and a brief cover letter to
[email protected] with the subject line “ Team Leader – Revenue Cycle Management (Hospital Billing) ” .
About SolvEdge
Solvedge: Pioneering the Future of Digital Healthcare
Our Expertise
SOLVEDGE stands at the forefront of digital healthcare innovation as a premier healthcare performance company. With over 18 years of dedicated service in the healthcare industry, we specialize in a digital care journey platform that revolutionizes how hospitals and health systems engage, monitor, and connect with patients throughout their healthcare experiences. Our partnership with Fortune 100 medical device companies and hospitals nationwide underscores our position as a trusted partner in healthcare solutions.
Key Features of SOLVEDGE
Our platform is designed to empower healthcare providers with the tools they need to automate and streamline care delivery, thereby improving clinical outcomes and patient satisfaction:
Personalized Care Plans: Leveraging evidence-based data, SOLVEDGE delivers digital care plans customized to meet the individual needs and conditions of each patient.
Real-Time Patient Monitoring: Through daily health checks, assessment, surveys, and integration with wearable devices, our platform facilitates continuous monitoring of patient health.
Automated Care Delivery: We automate essential tasks, including appointment scheduling, sending reminders, and delivering educational content, to enhance patient engagement and reduce administrative tasks.
Remote Patient Monitoring: Healthcare providers can monitor vital signs, symptoms, and treatment plan adherence remotely, enabling timely interventions and proactive care management.
The SOLVEDGE Advantage
Our platform offers significant benefits to healthcare providers and patients alike:
Improved Clinical Outcomes: By facilitating more effective care pathways and enabling early intervention, SOLVEDGE contributes to reduced readmission rates, fewer emergency department visits, and shorter hospital stays.
Enhanced Patient Satisfaction: Patients enjoy a higher quality of care with SOLVEDGE, benefiting from improved communication, comprehensive education, and continuous support.
Cost Savings: Healthcare organizations can achieve substantial cost reductions by minimizing unnecessary readmission, emergency visits, and complications associated with poor care management.
Applications and Impact: SOLVEDGE’s versatility allows for its application across various aspects of healthcare, with a particular emphasis on surgical care. From preparing patients for surgery to monitoring their post-operative recovery, our platform ensures a seamless and supportive care journey. Beyond surgical care, our focus encompasses managing care pathways, enhancing patient engagement through patient-reported outcomes, providing advanced data analytic, integrating with electronic medical records (EMR), and streamlining billing processes. Our comprehensive approach addresses the myriad challenges faced by today’s healthcare industry, backed by our commitment to excellence in service, communication, and customer experience.
A Trusted Partner in Healthcare Innovation: Our strategic relationships and deep understanding of healthcare challenges have positioned us as an indispensable ally to healthcare providers nationwide. As we continue to develop innovative solutions, our goal remains unchanged: to simplify healthcare delivery, improve patient outcomes, and enhance the overall patient experience.
