Process Lead - AR Calling (Hospital Billing)

7 - 12 years

8 - 10 Lacs

Posted:4 days ago| Platform: Naukri logo

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Job Type

Full Time

Job Description

We are seeking an experienced Process Lead AR Calling with strong expertise in Hospital Billing to lead end-to-end Accounts Receivable operations. The ideal candidate will have 7+ years of hospital billing experience, with in-depth knowledge of inpatient and outpatient claims, denial management, and payer follow-ups. This role requires hands-on leadership, process ownership, and strict adherence to healthcare compliance standards.

Role & responsibilities

  • Lead AR calling operations exclusively for hospital billing (IP & OP claims).
  • Manage and mentor a team of 2030 AR Callers

    , ensuring productivity, quality, and collections targets are met.
  • Oversee follow-ups on unpaid, underpaid, aged, and high-dollar hospital claims.
  • Perform and guide root cause analysis (RCA) for denials and payment delays; drive CAPA.
  • Manage complex denials related to DRG, coding, medical necessity, authorization, LOS, and timely filing.
  • Review and approve hospital appeals within payer timelines.
  • Conduct team huddles, performance reviews, coaching, and training sessions.
  • Act as escalation point for payer, client, and internal stakeholder issues.
  • Ensure compliance with HIPAA, ERISA, CMS, and hospital billing standards.
  • Prepare and review AR dashboards, aging reports, denial summaries, and collection performance reports.

Collaborate with QA, coding, WFM, and client stakeholders to improve hospital AR outcomes

Preferred candidate profile

  • 7+ years of

    Hospital Billing AR experience

    (mandatory).
  • Minimum 23 years of team handling experience

    (mandatory).

20+ resources

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