RCM Project Lead

About the Role

We are seeking a highly motivated and experienced RCM Project Lead to oversee and drive the end-to-end Revenue Cycle Management (RCM) services for our valued healthcare provider clients. In this pivotal role, you will lead cross-functional teams, ensure seamless RCM operations, and guarantee compliance with healthcare regulations and payer requirements. As the primary liaison between our organization and the client, you will be instrumental in achieving key performance indicators (KPIs), delivering exceptional service quality, and fostering strong customer satisfaction through strategic collaboration with hospital leadership and internal stakeholders.

Key Responsibilities

• Strategic Leadership: Lead and manage the full RCM lifecycle, from patient registration, eligibility verification, and pre-authorization to charging, coding, billing, claims submission, denial management, follow-up, and collections, ensuring adherence to best practices and regulatory standards.
• Team Management: Supervise and mentor a high-performing RCM team, assigning tasks, monitoring workloads, and fostering a culture of accountability, efficiency, and continuous improvement to meet operational and financial targets.
• Compliance & Quality Assurance: Ensure strict compliance with healthcare regulations, including CCHI, Saudi healthcare regulations, and CBAHI standards, as well as payer-specific requirements, to mitigate risks and uphold the highest standards of service delivery.
• Performance Monitoring & Optimization: Analyze RCM performance metrics, identify root causes of claim denials or inefficiencies, and implement data-driven corrective actions to enhance collections, reduce revenue leakage, and improve overall operational efficiency.
• Stakeholder Engagement: Act as the primary point of contact for clients, collaborating closely with hospital leadership, clinical teams, insurance providers, and internal departments to align RCM processes with organizational goals and deliver measurable results.
• Process Improvement: Drive continuous process enhancements by leveraging advanced RCM platforms, Hospital Information Systems (HIS), and Claims Management Systems to streamline workflows, reduce redundancies, and maximize revenue capture.
• Financial & Operational Oversight: Monitor key financial and operational KPIs, ensuring timely achievement of service-level agreements (SLAs) and maintaining a strong focus on client satisfaction and retention.
• Reporting & Analysis: Develop and present comprehensive reports using advanced Microsoft Excel skills, providing actionable insights to stakeholders and facilitating informed decision-making.

Qualifications & Skills

To excel in this role, you must possess the following qualifications and competencies:

• Education: Bachelor’s degree in Health Informatics, Healthcare Administration/Hospital Management, Business Administration, or Management Information Systems.
• Experience: Minimum of 5-7 years in Revenue Cycle Management, with at least 2 years in a team lead, project lead, or supervisory capacity.
• Technical Proficiency: Advanced Microsoft Excel skills with strong analytical and reporting capabilities; hands-on experience with RCM platforms, HIS, and Claims Management Systems.
• Regulatory Knowledge: Deep understanding of CCHI regulations, healthcare insurance compliance, Saudi healthcare regulations, and CBAHI standards.
• Analytical & Problem-Solving Skills: Proven ability to analyze RCM performance, identify trends, and implement corrective actions to optimize revenue cycles and operational efficiency.
• Communication & Collaboration: Excellent verbal and written communication skills in English, with the ability to engage effectively with stakeholders at all levels, including clients, hospital leadership, and internal teams.
• Project Management: Strong organizational skills with the ability to manage multiple priorities, deadlines, and projects in a fast-paced environment while maintaining high standards of accuracy and efficiency.
• Client-Facing Experience: Prior experience in managed healthcare services or client-facing roles is highly desirable.

Why Join Us?

As an RCM Project Lead, you will play a critical role in shaping the financial health and operational excellence of our healthcare clients. This position offers a unique opportunity to lead impactful projects, drive innovation in RCM processes, and contribute to the success of a dynamic and growing organization. If you are a results-driven leader with a passion for healthcare revenue cycle management, we invite you to apply and take the next step in your career with us.