[Hiring] RCM Team Lead @Gebbs Healthcare Solutions Inc

Role Description

• Provide day-to-day leadership and direction to team members supporting Intake, Authorization, and Scheduling functions.
• Coordinate daily workloads, assignments, priorities, and coverage to ensure operational requirements and service expectations are met.
• Serve as the first point of escalation for workflow questions, complex cases, payer issues, patient access concerns, and other operational challenges.
• Monitor team productivity, quality, attendance, responsiveness, and adherence to established processes.
• Conduct regular team meetings, individual coaching sessions, and performance discussions.
• Support onboarding and training of new team members and provide ongoing education as workflows, payer requirements, and client expectations change.
• Identify performance gaps and provide appropriate coaching, retraining, and escalation to management when necessary.
• Promote accountability, collaboration, and consistent execution across the team.

• Oversee intake and referral workflows to ensure patient demographic, insurance, referral, and required documentation is collected accurately and timely.
• Ensure eligibility and benefits verification is completed appropriately before services are provided.
• Monitor incomplete referrals and outstanding intake requirements and ensure appropriate follow-up occurs.
• Support escalation of complex eligibility, coverage, referral, and patient access issues.
• Ensure team members accurately identify and route prior authorization requirements during the intake process.

• Oversee prior authorization workflows, including eligibility verification, authorization submission, tracking, renewals, concurrent reviews, denial follow-up, and appeals.
• Ensure authorization requests are complete, accurate, and submitted within applicable payer timelines.
• Monitor pending and expiring authorizations and ensure appropriate follow-up occurs before services or authorized limits are impacted.
• Support team members with complex payer requirements, authorization issues, denials, and escalations.
• Monitor authorization-related denial trends and work with operational leadership to identify opportunities for process improvement.
• Ensure accurate documentation of authorization numbers, approved services, effective dates, expiration dates, visit limits, and other payer requirements.

• Oversee ongoing patient scheduling, rescheduling, cancellations, no-show follow-up, waitlists, and appointment reminder workflows.
• Ensure scheduling activity appropriately considers provider availability, service requirements, patient needs, and authorization status.
• Monitor provider utilization and open appointment capacity and work with the team to minimize unfilled appointment slots.
• Ensure pending, expired, or incomplete authorizations are identified before affected services are scheduled.
• Support escalation of scheduling issues that may affect patient access, provider utilization, reimbursement, or continuity of care.
• Monitor scheduling trends and work with operational leadership to address capacity constraints and recurring workflow issues.

• Monitor team performance against established productivity, quality, accuracy, turnaround time, and service-level expectations.
• Track and report key operational metrics across Intake, Authorization, and Scheduling functions.
• Review work for accuracy and compliance and participate in quality assurance activities.
• Identify trends, workflow gaps, recurring payer issues, and performance concerns and recommend corrective actions.
• Assist management with reporting, workload forecasting, staffing needs, and resource allocation.
• Maintain accurate documentation of team performance, coaching, training, and operational issues.
• Support process improvement initiatives designed to improve patient access, authorization performance, scheduling efficiency, reimbursement readiness, and overall revenue cycle performance.

Qualifications

• Minimum of 3 years of healthcare Revenue Cycle Management experience, with experience in patient access, intake, insurance verification, prior authorization, scheduling, or related front-end RCM functions.
• Prior RCM experience supporting behavioral health services is required.
• Previous experience as a Team Lead, Senior Specialist, Supervisor, or similar role with responsibility for providing day-to-day direction to multiple team members.
• Strong understanding of insurance eligibility and benefits, prior authorization, payer requirements, patient access, scheduling, and their relationship to reimbursement.
• Experience working with commercial and managed care payers.
• Experience using payer portals such as Availity, NaviNet, and payer-specific platforms.
• Experience with EHR, practice management, scheduling, or other healthcare revenue cycle systems.
• Demonstrated ability to monitor productivity, quality, workload, and operational performance.
• Strong coaching, communication, organizational, and problem-solving skills.
• Ability to manage multiple priorities and operational workflows in a high-volume environment.
• Working knowledge of HIPAA and healthcare privacy and confidentiality requirements.
• Bilingual English/Spanish communication skills preferred.