[Hiring] RCM Lead - Front End @Optim

Role Description

Under the direction of the RCM Supervisor - Front End and/or Revenue Cycle leadership, the RCM Lead - Front End supports the daily front-end revenue cycle operations for Optim Orthopedics. This role serves as a working lead for:

• Patient access
• Insurance verification
• Financial clearance
• Scheduling/check-out support
• Point-of-service collections
• Front-end workflow resolution

The RCM Lead helps monitor daily work queues, supports staff training, escalates workflow barriers, and promotes accurate, timely, and patient-centered service.

Qualifications

• High school diploma or general education degree (GED); an associate degree or certificate in medical office administration preferred.
• Minimum of 2 years of experience in medical billing, front-end revenue cycle, collections, or accounts receivable; prior lead or training experience preferred.
• Minimum of 2 years of experience with insurance verification, patient access workflows, or financial clearance; experience with Athena Health or similar practice management systems preferred.
• Ability to read and comprehend simple instructions, short correspondence, and memos.
• Ability to write simple correspondence.
• Ability to effectively present information in one-on-one and small group situations.
• Ability to calculate figures and amounts such as discounts, interest, and percentages.
• Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions.
• Knowledge of Electronic Medical Records (EMR), preferably Athena Database software; Outlook and MS Word Processing software.

Requirements

• Support daily patient access operations, insurance verification, authorizations for surgery/MRI/therapy, claim creation support, scheduling/check-out workflows, and point-of-service collections.
• Ensure accurate and complete patient demographic and insurance data entry to reduce claim denials.
• Assist authorization and surgery coordination teams with financial clearance follow-up to help ensure established timelines are met.
• Support staff in resolving real-time patient issues related to scheduling, insurance, or financial responsibility.
• Support patient and insurance refund workflows by ensuring items are routed according to established workflow and compliance expectations.
• Provide in-person or virtual coverage during staffing gaps, high volume periods, or training transitions.
• Identify eligibility issues, authorization gaps, denial trends, and payer issues; escalate trends and recommended solutions to the RCM Supervisor and appropriate team members.
• Support front desk and billing staff in resolving patient billing inquiries and claim concerns.
• Assist with accuracy of receipt processing, reconciliation support, and monthly or yearly closing activities as directed by leadership.
• Ensure compliance with policies, procedures, and regulatory guidelines across all patient access and revenue operations.
• Participate in continuous improvement initiatives, including workflow enhancements and system upgrades.
• Prepare or assist with weekly productivity, performance, and workflow status reports for supervisor review.
• Must have flexibility with hours as needed for clinic.
• Follows proper security procedures at the close of each day to ensure facility safety.
• Assist with training, onboarding, and support for new recruits and trainees.
• Act as a point of contact for workflow questions and immediate escalations in the absence of the RCM Supervisor or department leadership.

Benefits

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Company Description

The noise level in the work environment is usually moderate.