Team Lead - Resubmission & Reconciliation

Lead the resubmission and reconciliation process for insurance claims, ensuring timely and accurate resubmissions, mitigating financial risk, and maintaining compliance with industry regulations.

• Manage timely resubmissions of claims denials and monitor payment behaviours of payors. • Improve resubmission quality to minimise denials. • Coordinate with physicians, insurance teams, and clinical documentation to secure necessary justifications. • Maintain KPI compliance and daily target TAT for the team. • Analyse root causes of denials, implement system rules, and educate staff. • Track payment discrepancies and report to management. • Collaborate with stakeholders to enhance overall resubmission and reconciliation efficiency.

• Minimum 4+ years’ experience in a leading resubmission role. • Certified professional coding certificate from a reputed institution. • Certified medical/paramedical certificate. • Strong medical background, negotiation, analytical, and leadership skills. • Ability to work with insurance companies and manage complex cases.

• Certified professional coding certificate from a reputed institution. • Certified medical/paramedical certificate. • Minimum 4+ years of experience in a similar role.