RCM Operations Lead

About the role

The RCM Operations Lead owns Prosper's revenue cycle day-to-day. This role sits at the center of our billing function—responsible for claim management, vendor oversight, managing our offshore RCM team, answering internal billing questions, and the operational work required to launch and maintain payer relationships across states.

This is a high-ownership role with real surface area. The person who thrives here moves fast, prioritizes relentlessly, and doesn't stop at the first answer when something doesn't add up. You will own end-to-end billing operations across the full claims lifecycle—from front-end insurance verification and prior auth through claim submission, follow-up, denial/rejection resolution, and back-end reporting.

Responsibilities

• Own end-to-end billing operations across the full claims lifecycle.
• From front-end insurance verification and prior auth through claim submission, follow-up, denial/rejection resolution, and back-end reporting.
• Lead and manage a team of 4+ offshore support staff.
• Set priorities, assign workstreams, review output, and keep the team on track.
• Serve as the escalation point when issues arise and ensure processes are running consistently and correctly across the team.
• Support ad-hoc RCM projects, including state launches, new payer setup, provider enrollment, and credentialing gaps for existing clinicians.

Requirements

• Hands-on RCM experience, with strong familiarity across the claims lifecycle: denials, rejections, adjustments, resubmissions.
• Comfortable in Availity and standard provider portals.

Qualifications

• Ownership-oriented. You keep workflows clean, follow up on open items without being asked, and treat the function like it's yours to run.
• Clear communicator. You surface what matters in a format others can act on, and you stay responsive to the teams that depend on you.
• Comfortable in a fast-moving environment. Startup or high-growth experience preferred. You manage multiple workstreams simultaneously and don't need heavy oversight to stay organized.
• Raise the bar. You're comfortable pushing back, flagging problems, and holding vendors and internal teams to a higher standard—even without formal authority.