Team Lead- Denials

1 - 5 years

5 - 8 Lacs

Posted:1 hour ago| Platform: Naukri logo

Apply

Work Mode

Work from Office

Job Type

Full Time

Job Description

About the Role

Were seeking a Denials Team Lead with hands-on experience across both inpatient and outpatient denials to drive overturns, reduce aged inventory, and prevent recurrence at the root cause. Youll lead a pod of denial analysts, set daily priorities, coach for quality and speed, and collaborate with Coding, Charge Entry, Registration, and Payer Relations to improve first-pass yield and cash acceleration.

Key Responsibilities

Team Leadership & Delivery

  • Lead a team of denial analysts across IP/OP workqueues; plan capacity, assign work, and monitor performance.
  • Run daily huddles; set targets for productivity, quality, and TAT; remove blockers and manage escalations.
  • Conduct 1:1s, coaching, cross-training, and performance reviews.

Denials Resolution

  • Review EOB/ERA, CARC/RARC codes, payer policies, and medical necessity criteria to build strong appeals.
  • Oversee timely filing, resubmissions, corrected claims, and second-level medical appeals.
  • Drive overturns on common IP denials (e.g., level of care, lack of medical necessity, DRG changes) and OP denials (e.g., bundling, NCCI edits, MUEs, modifiers, prior auth).

Quality, Analytics & Prevention

  • Own team KPIs: denial-to-resolution TAT, aged bucket reduction (90/120), first-pass acceptance, and QA.
  • Perform root-cause analysis by payer/denial reason/service line; partner with Coding to fix upstream leakage.
  • Maintain SOPs and payer playbooks; run calibration with QA.

Compliance & Documentation

  • Ensure HIPAA compliance, accurate account notes, and audit-ready documentation.
  • Track and meet payer-specific TATs and timely filing limits.

Mock Interview

Practice Video Interview with JobPe AI

Start Job-Specific Interview
cta

Start Your Job Search Today

Browse through a variety of job opportunities tailored to your skills and preferences. Filter by location, experience, salary, and more to find your perfect fit.

Job Application AI Bot

Job Application AI Bot

Apply to 20+ Portals in one click

Download Now

Download the Mobile App

Instantly access job listings, apply easily, and track applications.

coding practice

Enhance Your Skills

Practice coding challenges to boost your skills

Start Practicing Now

RecommendedJobs for You

mumbai, mumbai suburban, mumbai (all areas)

hyderabad, pune, mumbai (all areas)

chennai, tamil nadu, india