RCM Operations Lead

Job Description

Job Description

Prosper Health is on a mission to make life happier and healthier for autistic and neurodivergent adults.

Despite autism diagnoses increasing more than 5x in the past 25 years, autistic adults have been systematically overlooked. This has led to extremely poor outcomes, including high rates of co-occurring mental health conditions and a lower life expectancy. Prosper is here to change that.

We deliver specialized mental health services for autistic adults, covered by insurance. We've helped tens of thousands of people receive an autism diagnosis for the first time, work with neurodivergent-affirming therapists, and find belonging through community. Our outcomes meaningfully outperform traditional care for autistic adults, with substantially greater improvements in mood, anxiety, and quality of life.

Prosper is growing 3x year over year and are at mid-double-digit millions in run-rate revenue, with thousands of active clients and 400+ clinicians. We're a high-ownership, mission-driven team, building something that has never existed for autistic and neurodivergent adults.

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.

• 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.

• 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.