RCM Operations Lead

Unreal Gigs • $75K — $95K *
US-AnywhereRemote in New York, NY
Healthcare
5 - 7 years of experience
1 week ago
Job Overview by Ladders

Qualifications

  • 5+ years of hands-on revenue cycle management (RCM) experience
  • Strong familiarity with the claims lifecycle including denials and rejections
  • Experience with Availity and standard provider portals
  • Demonstrated ownership and operational responsibility
  • Effective communication with teams and stakeholders
  • Experience in fast-paced startups or high-growth environments

Responsibilities

  • Own end-to-end billing operations for the full claims lifecycle
  • Manage and lead a team of 4+ offshore support staff
  • Handle high volume of billing escalations from vendors and internal teams
  • Investigate patient responsibility questions and vendor escalations
  • Support ad-hoc RCM projects and state launches

Benefits

  • Collaborative culture that values kindness and high performance
  • Daily lunch gatherings to foster team bonding
  • Focus on integrating diverse perspectives from experts and advocates
  • Commitment to ambitious goal-setting and accountability
  • Opportunities to work with professionals from prestigious organizations and universities
Full Job Description
About the Role

Revenue cycle management is foundational to everything Prosper does. Our ability to collect accurately and efficiently on the care we deliver is what funds our clinical mission - and as we scale, the complexity of that function grows with us.

The RCM Operations Lead owns Prosper's revenue cycle day-to-day. This role sits at the center of our billing function - responsible for claim management, vendor oversight, managing our offshore RCM team, answering internal billing questions and the operational work required to launch and maintain payer relationships across states.

This is a high-ownership role with real surface area. The person who thrives here moves fast, prioritizes relentlessly, and doesn't stop at the first answer when something doesn't add up.
You Will

  • Own end-to-end billing operations across the full claims lifecycle. From front-end insurance verification and prior auth through claim submission, follow-up, denial/rejection resolution, and back-end reporting.
  • Lead and manage a team of 4+ offshore support staff. Set priorities, assign workstreams, review output, and keep the team on track. Serve as the escalation point when issues arise and ensure processes are running consistently and correctly across the team.
  • Manage a high volume of billing questions and escalations from vendors and internal teams - investigating patient responsibility questions, handling vendor escalations, and triaging high-priority items like medical record subpoenas and collection agency contacts.
  • Support ad-hoc RCM projects, including state launches, new payer setup, provider enrollment, and credentialing gaps for existing clinicians.


About you

  • 5+ years of hands-on RCM experience, with strong familiarity across the claims lifecycle: denials, rejections, adjustments, resubmissions. Comfortable in Availity and standard provider portals.
  • Ownership-oriented. You keep workflows clean, follow up on open items without being asked, and treat the function like it's yours to run.
  • Clear communicator. You surface what matters in a format others can act on, and you stay responsive to the teams that depend on you.
  • Comfortable in a fast-moving environment. Startup or high-growth experience preferred. You manage multiple workstreams simultaneously and don't need heavy oversight to stay organized.
  • You raise the bar. You're comfortable pushing back, flagging problems, and holding vendors and internal teams to a higher standard - even without formal authority.


More about Prosper Health
  • Our culture is a unique mix of thoughtfulness, kindess, and high-performance. We take time to eat lunch together every single day in NYC, while also setting ambitious goals and holding ourselves accountable to them.
  • We always ensure that we integrate perspectives from experts in our space, including clinicians and autistic self-advocates.
  • Our team members come from places such as Bain, McKinsey, BCG, FirstHand Health, Rula, SeatGeek, Benchling, and schools like Harvard, MIT, Stanford, Yale, Penn, Dartmouth, Northwestern, Vanderbilt, and more.
  • Here are a few of our favorite operating principles:
    • Clients first - Our job is to solve real problems for our clients. Choose what makes life better for the client, even if it's harder for us. Never lose sight of the person on the other side.
    • Find a Way - We use ingenuity, scrappiness, and determination to bend the world to accomplish our goals. We're resourceful and do more with less.
    • Raise the Bar - We grow deliberately, by asking how things can improve and by giving and seeking feedback. We insist on the highest standards and keep pushing them higher.
    • Be a Good Person - Be kind, be honest, and make it fun to work here. Tell the truth even when it's uncomfortable. Treat people with respect and go out of your way to do nice things for your teammates.

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