Role & responsibilities

- Lead and manage the day-to-day activities of the Accounts Receivable and Denial Management team.
- Provide end-to-end knowledge and expertise in US healthcare AR and Denial Management.
- Monitor and drive effective AR follow-up with insurance payers to ensure timely claim resolution and reimbursement.
- Review and analyze EOBs/ERAs to identify denials, underpayments, contractual discrepancies, and other payment issues.
- Handle and guide the team on complex and high-value claims, including appropriate follow-up and escalation.
- Ensure timely and effective resolution of denied, rejected, unpaid, and underpaid claims.
- Monitor and manage aging AR buckets, including 30, 60, 90, and 120+ days.
- Analyze AR trends, identify root causes, and implement corrective actions to reduce aging and improve collections.
- Ensure accurate understanding and application of CMS-1500 and UB-04 claim forms.
- Maintain strong knowledge of payer-specific guidelines, reimbursement policies, billing regulations, and healthcare insurance processes.
- Review account notes and ensure accurate and complete claim status updates and documentation.
- Track team productivity, quality, collection performance, and other key AR metrics.
- Conduct regular performance reviews, provide coaching, and support team members in achieving operational targets.
- Identify training gaps and provide process training, refresher sessions, and on-the-job coaching.
- Escalate complex payer issues, recurring denial trends, and critical accounts to the appropriate internal or client stakeholders.
- Prepare and analyze AR reports, productivity reports, aging reports, denial reports, and collection metrics.
- Collaborate with Billing, Coding, Payment Posting, Denial Management,



and other RCM teams to resolve account-level and process-related issues.
- Maintain effective communication and professional relationships with insurance payers, clients, patients, and internal stakeholders.
- Demonstrate strong communication, negotiation, problem-solving, and decision-making skills during payer follow-up and issue resolution.
- Ensure compliance with company policies, payer requirements, HIPAA guidelines, and applicable US healthcare billing regulations.
- Drive continuous process improvement initiatives to improve cash flow, reduce AR days, minimize denials, and increase overall collections.
- Ensure the team consistently delivers high standards of service excellence to patients, clients, and stakeholders.

Preferred candidate profile

- Minimum 6+ Years of experience into AR Caller Physician Billing, Denial Management(Semi Voice Process)
- And also minimum 6 months of experience as AR Team Lead on Papers.
- Strong experience in US Healthcare AR / Revenue Cycle Management.
- Proven experience in Denial Management and insurance AR follow-up.
- Prior experience in a Team Lead role is preferred.
- Solid knowledge of EOBs, ERAs, denials, underpayments, appeals, and claim status processes.
- Expertise in CMS-1500 claim forms.
- Good understanding of US healthcare insurance processes and payer guidelines.
- Strong knowledge of AR aging and account prioritization, particularly 30/60/90/120+ day accounts.
- Excellent analytical, documentation, and problem-solving skills.
- Strong verbal and written communication and negotiation skills.
- Ability to manage team performance, workload distribution, escalations, and productivity.
- Strong attention to detail and ability to work independently as well as within a team.
- Proficiency in MS Office/Excel and healthcare RCM systems is preferred.

📌 AR Caller Team Lead - Physician Billing (Hyderabad)
🏢 Talentboon Consulting
📍 Hyderabad