Revenue Cycle Team Lead

The Revenue Cycle Lead is a working supervisor responsible for the daily oversight and execution of all revenue cycle operations for our Federally Qualified Health Center (FQHC). This role provides direct supervision, training, and work direction to the Billing & Coding Specialist, ensuring the accurate and timely submission of medical, dental, and behavioral health claims in compliance with FQHC, HRSA, and payer regulations.

This is a hands-on leadership position. The Lead is the primary point of contact for resolving complex denials, payer disputes, and escalated patient financial concerns. They also perform high-level revenue cycle functions such as monitoring key performance indicators (KPIs), analyzing accounts receivable (A/R) aging reports, identifying systemic issues, and implementing process improvements. The Lead reports to the Chief Financial Officer and serves as a key strategic partner in ensuring the financial health of the practice.

Essential Functions

Supervision & Team Leadership

· Supervise, mentor, and train the Billing & Coding Specialist, providing daily work direction and serving as the first point of contact for questions and escalations Conduct regular one-on-one meetings, provide coaching and performance feedback, and assist with annual performance evaluations

· Onboard new staff and develop training materials and job aids to ensure team proficiency in all FQHC billing and coding procedures.

· Ensure the team meets productivity and quality goals by monitoring work queues and distributing assignments effectively

· Foster a collaborative, accountable, and patient-centered work environment

Billing, Coding & Claims Operations

· Oversee the end-to-end billing process, including coding, claim submission, payment posting, and A/R management, across all service lines (medical, dental, and behavioral health)

· Ensure accurate coding of services using ICD-10, CPT, CDT, and HCPCS codes, with a strong focus on FQHC-specific encounter billing using the T1015 code

· Monitor and improve claim submission processes to ensure clean claim rates and timely filing with primary and secondary insurance carriers

· Oversee denial management, including analyzing denial trends, preparing and submitting appeal letters, and implementing corrective actions to prevent future denials

FQHC-Specific Compliance & Patient Financial Services

· Ensure full compliance with all FQHC, HRSA, CMS, and state-specific Medicaid billing requirements, including the administration of the Sliding Fee Discount Program and charity care policies

· Serve as the subject matter expert for FQHC billing regulations, including encounter-based reimbursement and UDS reporting

· Assist the Billing & Coding Specialist with complex patient account resolution, including explaining EOBs, applying sliding scale adjustments, and setting up payment plans

· Handle escalated patient calls and in-person inquiries that require supervisory review or advanced problem-solving

Revenue Analysis & Reporting

· Monitor and report on key performance indicators (KPIs), including days in A/R, denial rates, clean claim rates, and cash collections

· Produce monthly financial and operational reports for leadership, identifying trends and recommending strategic improvements

· Analyze A/R aging reports to identify underpayments and root causes of payment delays, implementing corrective actions as needed

· Conduct regular internal audits of coding and billing accuracy to ensure compliance and identify training opportunities for the Specialist, This position reports directly to the CFO. The Revenue Cycle Lead is responsible for the direct supervision of the Billing & Coding Specialist.

· High school diploma or equivalent required.

· Associate degree in Business, Healthcare Administration, Finance, or a related field strongly preferred

· Bachelor's degree in a related field is a plus

Experience

· Minimum of 3-5 years of progressive experience in medical billing and revenue cycle management in a healthcare setting

· Prior experience in a Federally Qualified Health Center (FQHC) is preferred

· Supervisory, lead, or mentoring experience is required

· Demonstrated experience managing the full revenue cycle, including coding, billing, collections, denials management, and A/R follow-up

Knowledge, Skills & Abilities

· In-depth knowledge of FQHC billing practices, including T1015 encounter billing, the Sliding Fee Discount Program, and HRSA compliance requirements

· Expert proficiency in ICD-10, CPT, CDT, and HCPCS coding and documentation guidelines

· Strong understanding of Medicare, Medicaid, and commercial payer rules, regulations, and reimbursement methodologies

· Advanced proficiency with practice management systems, EMRs (e.g., eClinicalWorks preferred), clearinghouse platforms, and Microsoft Office Suite, especially Excel

· Strong analytical, problem-solving, and critical thinking skills, with the ability to interpret financial data and identify trends

· Excellent written and verbal communication skills, with the ability to explain complex information to patients with low health literacy

· Demonstrated ability to resolve patient financial concerns with professionalism, empathy, and accuracy

· Commitment to the mission of an FQHC, including providing high-quality care regardless of a patient's ability to pay

Physical Demands / Working Conditions

Work is performed in a standard office environment. This role requires frequent sitting for long periods, operation of standard office equipment (computer terminals, copiers, printers, telephones), eye-hand coordination, manual dexterity, and normal vision range. Frequent contact with patients, staff, insurance representatives, and vendors is expected. May require occasional lifting of up to 25 pounds., * Which Associate degree do you hold, Business, Healthcare Administration, Finance, or other related field?, * Medical billing: 3 years (Required)

• Revenue cycle management: 3 years (Required)

Pulled from the full job description Health insurance Retirement plan Paid time off Employee discount Vision insurance Dental insurance Life insurance, * Dental insurance

• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance