27 Sep
|
PrimEra Medical Technologies
|
Hyderabad
27 Sep
PrimEra Medical Technologies
Hyderabad
Role Summary The Team Lead AR & Denials is responsible for supervising a team of RCM associates, managing daily work allocation, monitoring performance, and ensuring process accuracy. This role requires strong domain expertise, handson problem solving, and the ability to guide the team toward meeting daily, weekly, and monthly KPIs
Experience Required
- 5-9 years of experience in Healthcare Revenue Cycle Management
- Strong working knowledge in Billing, AR follow****up, and Denials Management.
Key Responsibilities 1. Billing Operations
- Oversee daily billing tasks, ensuring accurate and timely claim submission
- Conduct quality checks on claims and ensure adherence to payer requirements
- Resolve complex billing edits, missing information, and claim validation issues
- Support the team in maintaining a high Clean Claim Rate and reducing billing rework
2. Accounts Receivable (AR) Follow-up
- Allocate and monitor AR worklists to ensure timely follow-up on outstanding claims
- Track progress against daily/weekly collection goals and AR aging targets
- Handle escalated or complex payer calls and negotiate resolutions
- Identify patterns in payer delays or partial payments and raise to AM/DM for corrective action
3. Denials Management
- Lead the team in identifying, categorizing, and resolving denials
- Conduct preliminary root-cause analysis and ensure timely submission of appeals
- Guide the team on payer-specific appeal requirements and documentation standards
- Work closely with upstream teams to reduce recurring technical and clinical denials
Performance Monitoring & Reporting
- Track team metrics such as:
- Productivity
- Quality/Accuracy
- TAT (Turnaround Time)
- Collections %
- AR Days
- Denial Rate
- Maintain dashboards, daily status reports, and performance trackers
- Highlight process issues, revenue leakage, and trends to the AM/DM
- Participate in internal audits and support corrective actions
Team Leadership & Support
- Provide coaching, feedback, and on-floor support to junior team members
- Conduct regular huddles to align team goals and share updates
- Train new hires and upskill existing team members on billing/AR/denial workflows
- Help resolve process-related queries and ensure SOP compliance
- Foster a positive, accountable, and learning-oriented team environment
Client and Internal Coordination
- Support AM/DM in client calls, reviews, and performance discussions
- Communicate updates on challenges, progress, and action plans
- Coordinate with cross-functional teams (Coding, Eligibility, Provider Teams, QA) to reduce issues
Skills & Competencies
- Strong knowledge of US Healthcare RCM processes: Billing, AR, Denials
- Good communication and ability to handle difficult payer interactions
- Analytical skills to identify trends and resolve issues
- Robust organizational and multitasking abilities
- Leadership qualities with the ability to mentor and guide a team
- Hands-on experience with RCM systems, billing scrubbers, and payer portals
Interested candidates can share the resume to
[email protected]
📌 Team Lead (Hyderabad)
🏢 PrimEra Medical Technologies
📍 Hyderabad