NIVA Health
Website:
nivahealth.com
Job details:
You know RCM. But you're ready to own it.
We're looking for a
Senior RCM Lead who doesn't just know how to work a revenue cycle — you know how to understand it as a business.
You can look at a denial rate, aging AR, clean claim rate or collections trend and tell us more than what happened. You can tell us
why it's happening, where we're losing money, what needs to change, and what you would do about it.
That's the person we're looking for.
At NIVA, this role will have significant ownership of our revenue cycle function and will work closely with senior leadership. You'll have the opportunity to build structure, establish performance visibility, improve processes, develop a team and help shape how RCM operates as we continue to grow.
This isn't a role for someone who wants to sit in the background and manage a queue.
We want you to own the function.
What You'll Own
RCM performance & strategy
- Establish and own meaningful RCM KPIs, including denial rate, AR days, clean claim rate, collections, aging and productivity
- Build clear reporting and use data to identify trends, risks and opportunities
- Lead recurring performance reviews and bring forward both what's working and what isn't
- Translate operational data into clear recommendations for senior leadership
- Identify revenue leakage and develop practical strategies to improve financial performance
Denials, appeals & payer performance
- Provide deep expertise across denials, appeals, AR and payer-related issues
- Identify recurring denial patterns and their root causes
- Drive corrective action rather than simply treating individual claims
- Partner with internal teams and payers to resolve systemic issues
- Bring strong knowledge of ICD-10, CPT, HCPCS and US payer processes
Operational improvement
- Assess the RCM operation end-to-end and identify where processes, systems or handoffs are creating unnecessary friction or lost revenue
- Lead process improvement initiatives and challenge inefficient ways of working
- Partner with technology, RPA and innovation teams to identify opportunities for automation
- Make sure we're improving the process before we automate it
Team leadership & workforce planning
- Build and lead a high-performing RCM team as the function grows
- Establish clear roles, expectations, KPIs and accountability
- Coach and develop team members so the operation becomes stronger and less dependent on any one individual
- Use workload, productivity and performance data to anticipate staffing requirements and plan for growth
Executive partnership
- Work directly with senior leadership and confidently communicate RCM performance, challenges and opportunities
- Don't wait to be asked when something isn't working
- Bring problems forward with context, options and recommendations
- Help leadership understand the financial and operational implications of RCM decisions
- Take ownership from identifying an issue through to implementation and measurable results
Requirements
What you'll bring
We're looking for someone with:
- 7+ years of progressive experience in US healthcare RCM or medical billing, with meaningful leadership responsibility
- Strong experience across the full revenue cycle
- Deep experience with denials, appeals, AR and payer processes
- Strong working knowledge of ICD-10, CPT and HCPCS
- Experience with Medicare, Medicaid and commercial payers
- Strong understanding of HIPAA and US healthcare requirements
- Experience leading an RCM team, function or outsourced RCM operation
- Demonstrated experience using KPIs and data to improve operational and financial performance
- Experience leading process improvement and/or automation initiatives
- Experience with workforce planning, team development and scaling operations
- Confidence working with senior leaders, executives and/or healthcare clients
Certifications such as
CPC, CRCR or CCS are preferred, but we're ultimately more interested in what you have
owned, improved and delivered than the letters after your name.
The person we're looking for
You're probably someone who gets frustrated when people show you a report without explaining what it actually means.
You naturally ask:
Why is this happening?
What is the root cause?
What are we doing about it?
How will we know if it worked?
You can get into the weeds when necessary, but you don't live there. You understand the detail
and the bigger picture.
You are commercially minded, analytical and comfortable challenging the status quo. You can work independently, make decisions, influence stakeholders and communicate confidently with executives.
Most importantly, you take ownership.
If you see a problem, your instinct isn't to explain why it's someone else's responsibility.
You Figure Out What Needs To Happen Next.
Why this role matters
NIVA is growing, and our RCM operation needs to grow with it.
We're looking for someone who wants to build something — not simply maintain an existing process.
You'll have the opportunity to shape the RCM function, establish the operating rhythm and performance standards, build the team beneath you, improve how we work and have a direct influence on the organization's financial performance.
If you're ready for a role where
your judgment, leadership and ability to see the bigger picture matter just as much as your RCM expertise, we'd like to hear from you.
Click on Apply to know more.
