Identify trends, recurring errors, and process gaps to recommend corrective actions.
Conduct denial analysis and share insights with the team to reduce avoidable rework.
Participate in special projects and process improvement initiatives to enhance efficiency and outcomes.
Encourage and engage team members in process optimization and skill development.
Coaching & Development
Provide timely and constructive feedback to team members (Liaisons) on performance, accuracy, and productivity.
Support team members through coaching, counseling, and guidance when they face challenges.
Strategize assignment distribution to balance workloads and focus on individual development.
Drive continuous learning and encourage best practices within the team.
All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA and other regulations, as appropriate.
Minimum Requirements
5+ years of experience in the U.S. healthcare domain, specializing in Accounts Receivable and Denial Management.
Strong knowledge of standard RCM practices and payer-specific requirements.
Proven experience providing coaching, mentoring, or floor support to operational teams.
Willingness to work flexible shifts and adapt to internal role movements as needed.
Education / Experience / Certification
Bachelor’s degree preferred.
Experience in U.S. healthcare BPO/RCM operations, specifically in A/R follow-up and denial management, is mandatory.
Exposure to patient accounting systems (Epic, Cerner, Meditech, NextGen, eCW, CareCloud, etc.) is preferred.
Advanced MS Excel and reporting experience required.
Certification in medical coding (CPC/CCS) or process improvement (Lean/Six Sigma) is an added advantage.
Skills & Technical Proficiency
Strong subject matter expertise in U.S. healthcare A/R, denial management, and RCM best practices.
Excellent coaching, feedback, and counseling skills to guide team members effectively.
Ability to identify performance gaps, analyze root causes, and recommend actionable solutions.
Strong organizational and time management skills with the ability to prioritize tasks.
Effective verbal and written communication skills for clear team and stakeholder interactions.
Advanced proficiency in MS Excel; working knowledge of MS Word, PowerPoint, and Google Suite.
Ability to work independently as an individual contributor while enabling team success.
High attention to detail, integrity, and commitment to compliance with HIPAA and company policies.
Key Results / Performance Indicators
KRA Category
Target / Metric
Weightage
Focus Areas / Comments
Production
≥ 65%
30.0%
Full ownership of assigned workload
Quality
≥ 99%
30.0%
Accuracy, compliance, and adherence to SOPs
Operational Excellence
Team Quality ≥ 99%
30%
Proactive mindset, accountability, and support for team success
Team Floor Support and Query handling
Reviewing Supervisor queue and providing training to reduce the same in future
Team Audit, Training and Cross-Skilling
Identify and prevent fraudulent work
Creating, updating and validating done checklists for team members
Initiatives
n
10.0%
Help identify trends, process improvements, error possibilities, changes to edits, Denial Analysis etc.
Working Environment/Physical Demands
Working Environment
General office environment: Works generally at a desk in a well-lighted, air-conditioned office, with moderate noise levels.
Periods of stress may occur.
Physical Demands
Activities require a significant amount of sitting at office and work desks and in front of a computer monitor.
Some walking and standing relative to interaction with other personnel.
Travel Requirements
xNone Occasional Moderate Frequent Very Frequent
(25% or Less) (25% - 40%) (40% - 80%) (80% or m
Other possible Unofficial Titles
Unofficial titles may be given by the manager and used for email signature.
Note: Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. This document does not create an employment contract, implied or otherwise. It does not alter the "at will" employment relationship between the company and the employe
individual contributor
