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Commure - Team Lead - Denial Management - India

Commure - Team Lead - Denial Management - India

CommureGurgaon, India
7 days ago
Job description

At Commure, our mission is to simplify healthcare.

  • We have bold ambitions to reimagine the healthcare experience, setting a new standard for how care is delivered and experienced across the industry.
  • Our growing suite of AI solutions spans ambient AI clinical documentation, provider copilots, autonomous coding, revenue cycle management and more - all designed for providers & administrators to focus on what matters most : providing care.
  • Healthcare is a $4.5 trillion industry with more than $500 billion spent annually on administrative costs, and Commure is at the heart of transforming it.
  • We power over 500,000 clinicians across hundreds of care sites nationwide - more than $10 billion flows through our systems and we support over 100 million patient interactions.
  • With new product launches on the horizon, expansion into additional care segments, and a bold vision to tackle healthcare's most pressing challenges, our ambition is to move from upstart innovator to the industry standard over the next few years.
  • Commure was recently named to Fortune's Future 50 list for 2025 and is backed by world-class investors including General Catalyst, Sequoia, Y Combinator, Lux, Human Capital, 8VC, Greenoaks Capital, Elad Gil, and more.
  • Commure has achieved over 300% year-over-year growth for the past two years and this is only the beginning.
  • Healthcare's moment for AI-powered transformation is here, and we're building the technology to power it.
  • Come join us in shaping the future of healthcare.

About The Role :

  • We're 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.
  • You'll 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 (level of care, lack of medical necessity, DRG changes) and OP denials ( 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.
  • Commure is committed to creating and fostering a diverse team.
  • We are open to all backgrounds and levels of experience, and believe that great people can always find a place.
  • We are committed to providing reasonable accommodations to all applicants throughout the application process.
  • (ref : iimjobs.com)

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    Team Lead • Gurgaon, India

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