The Team Lead - Acute Billing Operations is responsible for day‑to‑day operational performance and execution for assigned clients, serving as the primary operations liaison between client facilities and internal delivery teams. This role focuses on tactical revenue cycle outcomes, ensuring accurate reporting, effective communication, and consistent execution across full-cycle claims processing. (billing, follow‑up, collections, denials, and claim resolution workflows)
This position is accountable for operational monitoring and client relationship management. The Team Lead translates client needs into clear operational priorities, monitors key performance indicators, identifies risks and trends, and supports timely issue resolution to protect cash, A/R performance, and client satisfaction.
The role also provides operational mentorship to staff by reinforcing daily best practices, supporting training and performance efforts, and helping remove execution barriers. Success is measured by client retention, escalation volume, and core revenue cycle performance indicators.
These Goals and objectives are not to be construed as a complete statement of all duties performed; employees will be required to perform other job-related duties as required. Goals and objectives are subject to change.
All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA and other regulations, as appropriate.
Essential Functions: In addition to meeting performance expectations, this role includes the following specific responsibilities:
Discrete Responsibilities (Primary Accountability)
- Operational Performance Monitoring: Monitor daily operational performance, battle cards, action plans, and key KPIs for assigned clients, including A/R days, cash performance, denial trends, and accuracy measures.
- Primary Operations Liaison: Act as the primary operational point of contact between clients and internal delivery teams, ensuring timely, accurate, and consistent communication.
- Operational Translation: Translate client needs, issues, and requests into actionable operational priorities and execution plans.
- Risk & Trend Identification: Identify operational risks, analyze performance trends, and support issue resolution to prevent revenue leakage and service disruption.
- Reporting & Communication: Ensure accurate reporting, clear status updates, and effective issue communication to internal stakeholders and, as appropriate, client contacts.
- Client Scope: Lead operational work for domestic‑only clients as needed.
Reporting, Trend Monitoring & Continuous Improvement
- Trend Monitoring & Corrective Action: Review statistical reports and dashboards to identify operational trends, risks, and deficiencies; develop and implement corrective action plans to improve timeliness, quality, and outcomes.
- Operational Efficiency: Lead tactical efforts to maximize operational efficiency and optimize reimbursement through standardized workflows, issue triage, and collaboration with cross-functional partners.
Client & Stakeholder Relationship Management (Tactical)
- Liaison & Communication: Act as the primary operational point of contact between facility management and internal teams, ensuring smooth, timely communication and resolution of day-to-day issues.
- Service Responsiveness & Escalation: Ensure client inquiries are addressed promptly (including providing timelines to resolution), and proactively escalate risks such as unbilled accounts, claim issues, and operational blockers to leadership.
- Cross-Functional Coordination: Partner with internal teams (e.g., operations, finance, payer relations, technology, and strategic client management/sales counterparts) to drive resolution and maintain a consistent client experience.
- Contract Awareness & Compliance: Understand contract terms and ensure operational billing, invoicing, and service delivery remain within negotiated requirements.
Compliance & Professional Standards
- Regulatory Knowledge: Maintain current knowledge of hospital billing systems, government payer programs, third-party reimbursement policies, and applicable federal/state regulations.
- Confidentiality: Maintain confidentiality of patient and client information without exception.
- Continuous Learning & Industry Awareness: Attend required meetings and remain current on industry trends, legislative changes, and best practices.
- Customer Invoicing & Accuracy: Ensure accuracy of customer invoices and support monthly invoicing processes as required; validate supporting detail and address discrepancies.
- Management Expectations / Additional Duties: Perform all functions in alignment with management expectations and complete other duties as assigned.
Key Measures of Success
- Client Retention and Stability
- Reduction in Client Escalations
- Cash Performance vs. Goal
- A/R Days and Denial Trends
Staff Management
Responsible for ensuring area of responsibility has the talent and resources to meet short- and long-term organizational goals as well as ensuring maximum productivity and performance. Responsibilities include, but are not limited to:
- Proactively recruit, screen, and select candidates for current and future resource requirements.
- Effectively orient new hires to ensure a positive and productive employee engagement experience.
- Ensure structure and hiring plans (within budget) are appropriate for performance and productivity levels required.
- Utilize the company’s performance management program as designed to align individual performance to overall performance objectives. Meet all completion requirements at a high quality level. Provide ongoing performance feedback. Identify and take appropriate action for non-performance.
- Ensure each employee has a yearly performance review that is reviewed with employee and the review to be sent to Human Resources each year.
- Ensure each employee has a clear and thorough understanding of their role and responsibilities. Keep job descriptions current for each position.
- Actively support and participate in organizational development and training programs. Meet all completion requirements at a high quality level.
- Mentor, guide, and coach direct reports in order to expand their capabilities and performance.
- Communicate all corporate matters in a positive and timely manner as directed by Corporate Communications or senior managements.
- Administer all internal policies and procedures in accordance with corporate, human resources, budgetary, and finance guidelines. Ensure accuracy of staff data records.
- Comply with all employment laws and regulations including, but not limited to, equal employment opportunities for all.
Minimum Requirements:
Education/Experience/Certification Requirements
- Experience leading/managing a team of 5-10 direct reports (Claims Billers)
- 5+ years of experience in Acute hospital revenue cycle functions with strong exposure to FULL-CYCLE billing and follow-up/collections and claim resolution.
- Working knowledge of insurance regulations, reimbursement practices, procedure and diagnosis coding, and automated billing workflows.
- Demonstrated ability to work issues to resolution, including complex account research, root cause identification, and corrective actions.
- Strong client-facing communication skills (written and verbal) with the ability to explain operational findings, timelines, and next steps clearly.
- Excellent critical thinking, organizational, and time-management skills with strong attention to detail, accuracy, and follow-through.
- Proficiency with Microsoft Office (Excel, Outlook, Word) and comfort working across multiple systems and reporting outputs.
- Bachelor’s degree or equivalent combination of education and relevant experience (to support internal flexibility for hiring and promotion).
Preferred Qualifications:
- 2+ years Medicare hospital billing experience and/or demonstrated expertise with government payers (Medicare/Medicaid).
- Experience supporting hospital billing platforms and/or EHR/RCM systems (e.g., Thrive, Epic, Cerner, or comparable tools).
- Advanced revenue cycle analytics capability (e.g., trending denials/underpayments, operational KPI reporting, dashboard interpretation).
- Prior experience in a role requiring client management, escalations, service recovery, and cross-functional coordination.
- Exposure to invoicing processes, contract compliance validation, and operational performance governance.
Manager
