Revenue Cycle Management Lead

Responsibilities

• New service line launch claim success: Define claim success benchmarks (clean claim rate, paid claim rate) for every new service line launch or expansion. Monitor performance through ramp-up and resolve configuration, routing, or coding issues quickly. Support Service Line projects such as discovery, specifications, rate review, etc.
• Coding automation strategy & audit: Own the coding automation roadmap — where automation reduces manual coding load and how it gets prioritized. Run recurring coding accuracy audits, identify systemic errors, and drive fixes with the Coding Manager.
• Eligibility performance & metrics: Own eligibility/benefit verification performance metrics (match rate, response time, accuracy). Diagnose degradation and drive resolution with the RCM Manager, Engineering, and Payer Contracting. Build and maintain the eligibility performance dashboard in partnership with Engineering.
• Cross-functional RCM strategy: Take on emerging high-priority RCM problems as directed — denial spikes, payer-specific issues, fee schedule anomalies, service line discovery. Represent RCM performance and strategy in cross-functional forums.
• Reporting: Build and maintain a regular RCM performance report for the Head of Revenue Operations, synthesizing coding, eligibility, and claims data into a single view.

Requirements

• Analytical rigor — builds and reads metrics/dashboards, gets to root cause from data rather than anecdote
• Influence without authority — drives change inside the Coding Manager's and RCM Manager's teams as a peer/strategic partner, not their boss
• Deep domain expertise — genuinely knows coding, eligibility, and claims mechanics well enough to audit and improve them personally
• Strategic and hands-on — can define a roadmap and also run the audit or pull the data personally; this isn't a role for someone who only manages through others
• Comfortable without headcount — measures success through outcomes and influence, not team size