RCM Front End Lead Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Guide and manage the configuration and establishment of new client billing accounts.

• Collaborate with Engineering, Credentialing, Eligibility, and Finance teams for onboarding and payment configuration.

• Maintain comprehensive documentation for onboarding, configuration, and updates to customer contracts.

• Take ownership of the Price Book across billing and payer configurations.

• Lead testing processes for billing to ensure configurations are validated and to mitigate downstream issues.

• Incorporate eligibility, benefit, and coding information into billing configurations.

• Create documentation, suggest automation, and enhance implementation workflows.

• Act as a subject matter expert in front-end RCM processes and system integrations.

• Supervise Data and Charge Entry contractors and the deliverables of full-time employees.

• Spearhead process improvement initiatives aimed at automation, accuracy, and scalability.

• Propel enhancements in Athena, Zuora, and Salesforce systems.

• Mentor junior team members and contractors.

• Address discrepancies and unify stakeholders through documentation, updates, and cooperative planning.

• Achieve mastery of core RCM platforms and client/payer billing requirements within the first 90 days.

• Prioritize tasks for the Charge Entry team and spearhead process enhancement initiatives.

• Collaborate across departments to resolve system inefficiencies and align end-to-end processes.

• Cultivate relationships with contractors and document best practices.

⛳️ Requirements

• 3–5+ years of experience in healthcare revenue cycle management, particularly in direct billing and payer implementations.

• Demonstrated success in managing complex accounts, addressing escalations, and resolving exceptions.

• Experience supervising Data and Charge Entry contractors.

• Advanced knowledge of commercial and government payer policies, reimbursement methods, and contract stipulations.

• Proficient understanding of CPT, HCPCS, and ICD-10 coding.

• Experience in leading small projects or initiatives focused on process improvement.

• Capability to analyze data, recognize trends, and construct reporting frameworks.

• Familiarity with product development or systems optimization is preferred.

• Strong technical skills with Athena, Zuora, Salesforce, and JIRA or comparable RCM systems.

• Exceptional communication abilities and a collaborative, solutions-oriented approach.

• Proactive utilization of AI tools to enhance output and efficiency.

• Legally authorized to work in the United States.

• Must indicate whether employment visa sponsorship is required.

🏝️ Benefits

• Equity offered.

• Remote-first work arrangement.

• Security and privacy training provided.

• Location-based compensation structure.