Lead Revenue Cycle Specialist

Overview GI Associates is looking for motivated people to join our growing independent gastroenterology practice. Our nationally recognized physicians and dedicated team are patient-focused and provide compassionate, collaborative care to patients across Southeast Wisconsin. GI Associates provides an excellent work-life balance and amazing benefits package including: No weekends No Holidays PTO & paid anniversary day 7% GI Associates retirement contribution & 401(k) plan Medical, dental & vision insurance Flexible spending plan Short- & long-term disability Basic & supplemental life insurance Position Summary The Revenue Cycle Specialist Team Lead plays a key role in fostering a positive, high-performing work environment while working independently and leading a collaborative Revenue Cycle team. This position provides day-to-day operational leadership for billing and accounts receivable functions, including workflow oversight, coaching, and support of Revenue Cycle staff to ensure timely, accurate, and efficient operations. The Team Lead serves as a subject matter expert in clean claim submission, reimbursement processes, payer follow-up, and issue resolution, acting as the first-level escalation point for complex billing issues. This role monitors productivity and quality metrics, ensures payer compliance, and partners closely with management to drive process improvement, revenue integrity, and optimal financial performance. Essential Duties & Responsibilities Operational Oversight & Work Management Provide daily operational oversight of Revenue Cycle workflows to ensure timely and accurate billing, follow-up, and resolution of accounts. Assign, prioritize, and rebalance work queues based on payer type, aging tiers, high-dollar accounts, and timely filing risk to meet daily and weekly performance targets. Monitor overall departmental workload and adjust staffing assignments to ensure coverage, including PTO/FMLA and cross-training needs. Manage staff scheduling, attendance, coverage, PTO coordination, and cross-training to maintain consistent and uninterrupted department operations. Escalations, Claims & A/R Management Serve as the first-level escalation contact for complex billing issues, payer disputes, appeal coordination, and cross-departmental barriers (e.g., coding edits, authorization, eligibility). Investigate escalated insurance billing inquiries, discrepancies, and inaccuracies; take appropriate corrective action to resolve accounts. Handle escalated payer and patient phone calls that cannot be resolved by the frontline Revenue Cycle staff. Ensure timely and accurate claim submission via electronic systems, payer portals, or mail as required. Monitor EDI dashboards to identify, troubleshoot, and resolve rejected or failed claims; submit and manage clearinghouse support tickets as needed. Performance Monitoring, Audits & Revenue Integrity Monitor Revenue Cycle Specialist productivity and quality metrics; provide real-time coaching and conduct monthly one-on-one meetings with documented feedback and action plans. Establish, track, analyze and communicate key performance indicators (KPIs), including days in A/R, denial rate, collection rate, net revenue, and write-offs. Conduct regular audits to ensure billing accuracy, documentation completeness, and compliance with payer and regulatory requirements. Implement corrective actions, workflow adjustments, and process improvements based on audit findings and performance trends. Monitor billing and reimbursement trends and collaborate with leadership to reduce write-offs and improve overall collections and revenue outcomes. Training, Coaching & Staff Development Coach and mentor team members, recognize strengths, and encourage accountability and ownership of professional development. Provide ongoing training and education related to payer guidelines, denial trends, workflows, and revenue cycle best practices. Lead or support team meetings and huddles using structured agendas to communicate priorities, performance trends, bottlenecks, systemic issues, and team successes. Assist with recruitment, interviewing, onboarding, training, competency development, and annual performance evaluations. Maintain and update training resources to ensure all onboarding materials – including SOPs, payer guides, workflows, tip sheets, and competency checklists – remain accurate, current, and accessible to all staff. Compliance, Communication & Collaboration Maintain current knowledge of payer requirements, insurance policies, CPT/ICD-10 updates, and applicable regulations to ensure ongoing compliance. Proactively inform management of reimbursement changes, payer policy updates, and market or regulatory trends impacting revenue. Provide ad hoc support to Revenue Cycle staff via phone, email, Teams, or in person to assist with issue resolution and workflow questions. Collaborate with internal departments to identify and resolve systemic revenue cycle issues. Additional Responsibilities Participate in special projects and initiatives as assigned by management. Perform other duties as assigned to support Revenue Cycle operations. Work location may be hybrid or onsite, based on business needs and direction from the Manager or Director of Revenue Cycle Management. Minimum Qualifications High School diploma or equivalent required Associate or bachelor’s degree in healthcare administration, business or billing and coding preferred 3–5 years of progressive experience in revenue cycle operations Strong knowledge of healthcare billing, claims processing, denial management, and payer requirements Prior experience leading, mentoring, or serving as a senior subject resource matter for a team Excellent written and verbal communication skills; communicates professionally and effectively Strong attention to detail with the ability to manage competing priorities in a fast-paced environment Able to work independently with minimal supervision and adapt to changing priorities Proficiency with EHR/practice management systems Physical & Mental Demands Must be able to sit for extended periods of time Ability to manage frequent interruptions and multiple priorities in a fast-paced, dynamic environment Requires extended periods of computer use and occasional overtime during peak billing cycles Frequent use of the telephone and electronic communication tools. #J-18808-Ljbffr GI Associates