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Prosperhealth
Prosperhealth

RCM Operations Lead

operationsfull-timeNew York, New York, United States; Remote
SALARY
Not listed
WORK TYPE
remote
JOB TYPE
full-time
INDUSTRY
healthcare
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About the role

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

  • 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.
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