Job Title: Team Lead – Accounts Receivable (AR) Follow-up & Denials

Function / Vertical: Revenue Cycle Management (US Healthcare)

Employment Type: Full-Time, Permanent

Work Schedule: US Night Shift (Versatile to EST / CST / PST client alignments)

Position Summary

The Team Lead – AR Calling manages daily operations for an Accounts Receivable and Denial Management team. This role oversees a squad of 15–25 AR Callers and Senior AR Callers, ensuring strict adherence to productivity, quality, and resolution targets. The Team Lead identifies root-cause denial trends, reduces Days Sales Outstanding (DSO), resolves complex escalated claims, and coaches callers to maximize revenue collection across US commercial and government payers.

Key Responsibilities

1. Operations & Queue Management

- Allocate daily work queues, aging claims buckets (30, 60, 90, 120+ days), and high-dollar inventory across team members.
- Monitor real-time operational floor metrics, such as touched claims, calls per representative, call handle time, and resolution cycle times.
- Track and manage Timely Filing Limits (TFL) to eliminate uncollectible write-offs and bad debt.
- Act as an operational escalation point for high-dollar claim rejections, persistent non-payments, and payer disputes.

2. Denial Management & Root-Cause Analysis (RCA)

- Perform regular root-cause analysis on Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC).
- Drive structured resolutions for recurring denial types, including Coordination of Benefits (COB), Prior Authorization/Pre-cert, Medical Necessity, and Bundling/Unbundling issues.
- Collaborate closely with Charge Entry, Medical Coding, and Payment Posting teams to resolve upstream billing errors and process claim corrections/appeals.

3. Team Leadership, Quality & Coaching

- Supervise, mentor,



and conduct daily operational huddles with AR Callers.
- Review quality audit findings alongside QA analysts; calibrate call recordings and account documentation for accuracy and clarity.
- Run 1-on-1 performance coaching, upskilling sessions on payer policy changes, and Performance Improvement Plans (PIPs) when necessary.
- Manage roster scheduling, floor discipline, shift adherence, and leave planning.

4. Client Reporting & Governance

- Compile and publish Daily/Weekly End-of-Day (EOD) status reports, Work-in-Progress (WIP) summaries, and collector realization metrics.
- Prepare and participate in operational reviews, audit presentations, and client governance calls.

Qualifications & Experience

- Education: Bachelor’s degree in any discipline (Life Sciences, Commerce, Management, or Computer Applications preferred).
- Experience:
- 5+ years of hands-on experience in US Healthcare AR Calling & Denial Management.
- At least 1–2 years of formal team lead, supervisory, or senior SME track-record managing an operational team.
- Domain Expertise:
- Deep knowledge of US healthcare insurance payers: Medicare, Medicaid, Blue Cross Blue Shield (BCBS), UnitedHealthcare, Aetna, Cigna, and major regional HMOs/PPOs.
- Thorough grasp of Claim Forms (CMS-1500 / HCFA and UB-04 for hospital billing).
- Practical understanding of CPT, ICD-10, HCPCS, CCI edits, and billing modifiers.
- Working knowledge of clearinghouses (Availity, Change Healthcare, Waystar) and Practice Management / EHR software (Epic, Cerner, AthenaHealth, eClinicalWorks, Kareo, NextGen, or AdvancedMD).
- Compliance: Strong compliance adherence regarding HIPAA guidelines, PHI protection, and standard data privacy practices.
- Technical Skills: Advanced proficiency in Microsoft Excel (VLOOKUP, XLOOKUP, Pivot Tables, conditional formatting for aging analysis).

Pay: ₹30,000.00 - ₹45,000.00 per month

Work Location: In person

📌 AR Calling Team Lead (Hyderabad)
🏢 Elico HealthCare Services
📍 Hyderabad