Hiring Team Lead RCM Denial Management

Hiring Team Lead RCM Denial Management

HRCS Services pvt ltd

Jalahalli , Bengaluru

About HRCS Pvt Ltd:

HRCS Pvt Ltd is a fast-growing healthcare solutions provider specializing in end-to-end Revenue Cycle Management (RCM) services for clients across the U.S. We are committed to delivering quality, compliance, and timely service with a customer-centric approach.

Job Summary:

We are seeking a proactive and detail-oriented Denial and RCM Management Lead to oversee denial resolution, enhance revenue cycle performance, and manage a team of RCM professionals. This role demands a deep understanding of U.S. healthcare billing processes, payer policies, and a drive to optimize collections and reduce denials.

Key Responsibilities:

Denial Management:

• Review and analyze payer denials to identify trends and root causes.
• Work with internal teams to rectify and resubmit denied claims accurately and promptly.
• Reduce denial rates through preventive strategies and regular audits.

Revenue Cycle Oversight:

• Monitor and manage the entire RCM workflow including charge entry, claim submission, payment posting, and AR follow-up, and patient collections.
• Improve metrics such as First Pass Resolution Rate (FPRR), AR > 90 days, and Denial Rates.
• Ensure adherence to payer-specific guidelines, HIPAA, and compliance protocols.

Team & Client Management:

• Lead, mentor, and supervise a team of RCM and denial management specialists.
• Coordinate with cross-functional teams, including coding, billing, and client support.
• Serve as the escalation point for unresolved issues and ensure client satisfaction.

Reporting & Analytics:

• Prepare and deliver weekly/monthly performance reports and dashboards.
• Provide recommendations for process improvements based on data analysis.
• Stay updated with industry changes, payer policies, and billing regulations.

Qualifications & Skills:

• Minimum 7 years of experience in US healthcare RCM with a strong focus on denial management.

• In-depth knowledge of medical billing concepts, claim lifecycle and EOB analysis.

• Proficient in billing software like eClinicalWorks, Kareo, Athena, AdvancedMD, or similar

• Excellent communication, leadership, and analytical skills.

• Bachelors degree (any stream); Certification in RCM/Medical Billing/Coding is a plus