Remote RCM Team Lead - Pediatrics & Denials

PedsOne, LLC; Winooski (VT); Hybrid; USD 120,000 - 180,000; Full time

Benefits offered by this job

Health insurance

Vision & dental insurance

Short-term disability

3% retirement match

Paid holidays

Paid time off

Parental leave

Volunteer days

Job summary

PedsOne in Vermont is seeking a senior RCM leader to blend high-level billing strategy with hands-on day-to-day supervision of billers. You will drive performance and growth of the RCM team while collaborating with clients, payers, and providers to optimize reimbursements.

The ideal candidate has extensive outpatient pediatric billing experience, strong denial management skills, and proficiency across major billing platforms.

Qualifications

• Eight years of medical billing experience for outpatient physician services, with at least five in pediatrics.
• Minimum two years supervising a team of eight or more RCM staff.
• Ability to identify reimbursement trends and root causes of denials.
• Proven track record in denial resolution and appeals management.
• Proficiency with at least three major EHR/billing platforms.
• Hands-on leadership in high-volume billing environments (80–100 claims/day).

Responsibilities

• Lead 8–12 billing specialists, ensuring a positive, collaborative work culture.
• Oversee daily revenue cycle operations including insurance/patient collections and denials.
• Monitor performance metrics, conduct evaluations, ensure timely claim submissions.
• Serve as escalation point for client issues and drive cross-team communication.
• Manage multiple projects such as cleaning up AR and supervising other billers' work.

Skills

Medical billing expertise

Team leadership

Denials management

EHR/Billing platforms

Communication

Tools

eCW

Athena

PCC

EPIC

OP

Job description

The optimal candidate seamlessly blends high-level technical billing expertise with strategic operational leadership. This role requires a hands-on professional who works alongside their billers in the day to day RCM, while simultaneously managing the broader performance and growth of their team.

We hire for both remote and onsite positions.

Qualifications

• 8 years of medical billing outpatient physician services (5+ specifically in pediatrics)
• 2+ years supervising a team of 8 or more RCM staff
• Ability to identify reimbursement trends and root causes of denials
• Strong track record of denial resolution and successful appeals management
• Proficiency in at least 3 major EHR/Billing platforms
• Proven ability to manage 80-100 claims per day
• Professional communication with clients, providers, payers, and internal team
• Proactive, goal-oriented leadership with ability to foster a positive/motivating environment
• Demonstrated critical thinking and problem solving skills.
• CPC or CPB certification a plus

Ideal Characteristics

• Ability to manage through change, foster a positive/motivating environment, and demonstrate proactive, goal-oriented leadership.
• Strong conflict resolution, critical thinking, pattern recognition, and a proven record of self-driven problem-solving.
• Clear, confident, yet open communication style.
• Mission-driven, research-oriented, and value-adding mindset.
• Ability to speak with depth about billing experiences, utilizing specific examples.
• Core Revenue Cycle Execution: Entering charges, claim scrubbing, claim submission, handling Clearing House rejections/edits, posting insurance payments, appealing denials, and reconciliation.
• Payor Portal Management: Using payor portal log-ins, chat features, and online correction/resubmission tools to resolve issues while minimizing phone calls to payors.
• Account Management: Engaging in hands-on account management and task work for assigned clients to balance leadership duties.
• Technical Proficiency: Working within multiple billing/EHR systems (e.g., eCW, Athena, PCC, EPIC, OP) and managing high-volume billing (80–100 claims/day).
• AR Management: Maintaining strong Accounts Receivable management, including reporting and daily AR work .

Leadership & Oversight Responsibilities

• Mentorship & Supervision: Leading a team of 8–12 billing specialists, fostering a positive, collaborative, and accountable work environment.
• Operational Oversight: Managing daily revenue cycle operations, specifically insurance/patient collections, denial management, and coverage planning.
• Performance Management: Monitoring team performance metrics, conducting evaluations, and ensuring the accuracy and timely submission of claims.
• Communication & Escalation: Serving as the bridge between management and the team, providing guidance, addressing conflicts, and acting as the escalation point for client issues.
• Project Management: Managing multiple projects concurrently, such as overseeing other billers’ work and cleaning up neglected AR.

Additional Qualifications for Any Remote Work

The position is available fully remote for candidates who live beyond a reasonable commuting distance from our office in Winooski, VT. Local Vermont candidates are invited to apply for a hybrid position (3 days in office, 2 days remote).

• A private, dedicated space to ensure HIPAA compliance
• Sufficiently high speed and reliable internet service to perform the job. Download speed: optimal 10-20 mbps. Upload speed: over 5 mbps. Latency: under 50 is ideal. (Anything above 100 ms will not work.) A speed test for these metrics is available at https://speedof.me/
• Health, vision, dental insurance, and short-term disability
• CTO accrued from the 1st day of employment, beginning with 2 weeks
• 6 paid holidays with 5 additional paid days
• 3 paid days for personal emergency
• Paid time off for volunteer community service
• Paid parental leave
• Employee retirement account with 3% matching