Revenue Cycle Management Lead

Job Locations US-CA-San Diego
Customer Service/Support
Category 2


Under the direction and supervision of Revenue Cycle Management Supervisor / Manager/ Director; The Lead Position is directly responsible to supervise, assist, train, and provide support to the Medical Billing Staff in all areas of Revenue Cycle Management daily operations.  Coordinates activities and schedules work assignments to meet billing deadlines. Familiar with a variety of medical billing/collection concepts, practices, and procedures. Relies on extensive experience and judgment to plan and accomplish goals.


Good working knowledge of HIPAA, HCPCS, CPT, ICD-10 codes. Ability to train and develop staff.  Must have excellent verbal and written communication skills.  Must have working knowledge of patient accounting functions, tools and processes applicable to medical claims.  Must be proficient in Microsoft Windows, Excel and Word, Adobe Acrobat.  Ability to quickly learn multiple operating systems; e.g., GH, and other patient accounting systems.  Ability to communicate with all levels. Superior attention to detail.


  • Supervise, assist, train, and provide support to staff
  • Provides daily directive to staff
  • Assigns worklist as necessary
  • Manage account receivable trends to include days outstanding, cash collections, and report AR trends.
  • Conduct research for payor guidelines or appeal steps
  • Responsible for overall secondary billing processes
  • Responsible for generating patient statement files
  • Maintain client review process and provide feedback to manager and upper management
  • Responsible for production review and production discussions with staff
  • Tracks staff attendance and disciplinary measures when necessary
  • Performs monthly customer adjustments such as collections
  • Reviews and approves monthly adjustment audits
  • Maintains and approves timecards
  • Correspondence and batch approval
  • Tracks and assists staff with Zirmed rejections and name matching
  • Responsible for payor library and creation of new payors
  • Validates and maintains payor specs
  • Responsible for billing mileage review
  • Tracks unbilled, monthly billed volumes, and past due payor acknowledgments
  • Provides feedback to manager and staff regarding payor trends
  • Responsible for Jira creation and tracking employee access requests
  • Responsible for maintaining all assigned customer accounts current
  • Works with manager on staff and AR issues
  • Claims follow up
  • Customized appeal letter writing
  • Ability to escalate and promptly resolve claims
  • Other duties as assigned



  • Good customer service skills
  • Works well under pressure to meet deadlines
  • Goal oriented to meet production, quality and budget standards
  • Demonstrates understanding of full scope of responsibilities and uses discernment to prioritize continuously
  • Makes decisions founded on data and facts
  • Contributes to process improvements and efficiencies
  • Prior management of 6+ employees
  • Solid understanding of the Fair Debt Practices 
  • Strong interpersonal and communication skills with the ability to communicate at all levels
  • Ability to read and understand an EOB
  • Able to understand and complete both professional and institutional medical claim forms
  • Understands working in a team environment for the success of the team
  • Ability to utilize PC using word, excel, custom billing software
  • Ability to work in a production environment
  • Experience in emergency medical services, medical dispatching, or patient registration will be helpful           
  • Maintains presentable personal appearance
  • Must adhere to all company safety, compliance, business ethics, and privacy regulations.
  • Initiative required learning company organization and procedures.
  • Is a team player and interfaces well with employees.
  • Represents the company with a positive, customer friendly attitude to other employees, clients, agencies, entities and patients.
  • Maintains a high level of confidentiality.
  • Demonstrates leadership by acting as a role model.  Setting the standard and living it each day. 




High School Diploma (GED equivalent) required and at least 2 years previous experience in billing/collections in a medical office, clinical site, or billing/collections office.  Type 35 WPM, 10 key by touch (30) Must have knowledge of general office procedures using office equipment.  Medical billing and coding certificate, preferred.    Must have PC skills and basic knowledge of Microsoft Office Word, Excel, and Outlook.  Must have prior experience with email and using the web.


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