Team Lead (DME)

TITLE: Team Lead – DME Billing Operations

Location: Jaipur

Experience: 4–8 Years

POSITION SUMMARY

We are seeking a dynamic and performance-driven Team Lead – DME Billing Operations to oversee daily operations within our Durable Medical Equipment (DME) Revenue Cycle Management (RCM) practice. The ideal candidate will be responsible for driving team productivity, ensuring quality deliverables, maximizing collections, and supporting operational excellence across DME Billing and Accounts Receivable functions.

The role requires strong expertise in DME Billing, AR Follow-up, Denial Management, Medicare/Medicaid Guidelines, Commercial Payer Processes, and Team Handling.

KEY RESPONSIBILITIES

Operations Management

• Lead and manage a team of DME Billing and AR Specialists.

• Ensure daily productivity, quality, and SLA targets are consistently achieved.

• Monitor work queues and ensure timely completion of assigned activities.

• Track operational performance and implement corrective actions as required.

• Drive adherence to client processes, billing guidelines, and organizational standards.

• Ensure timely claim submissions and effective follow-up on outstanding receivables.

Accounts Receivable & Denial Management

• Manage AR follow-up activities across Medicare, Medicaid, and Commercial Payers.

• Monitor AR aging and drive initiatives to improve collections and reduce outstanding balances.

• Review and resolve denied, rejected, and underpaid claims.

• Coordinate appeals, reconsiderations, and payer escalations where necessary.

• Identify denial trends and work with management to implement preventive measures.

• Monitor key metrics including:

o AR Aging

o Collections Performance

o Denial Rate

o Productivity

o Quality Scores

o Recovery Rate

Team Leadership & Development

• Provide day-to-day guidance, coaching, and support to team members.

• Conduct regular performance reviews and feedback sessions.

• Identify training needs and support skill enhancement initiatives.

• Drive employee engagement and foster a positive team environment.

• Assist in onboarding and mentoring new hires.

• Ensure team adherence to attendance, productivity, and quality expectations.

Client & Stakeholder Coordination

• Support managers in client reporting and operational reviews.

• Participate in internal and external stakeholder meetings as required.

• Escalate operational challenges and proactively recommend solutions.

• Ensure effective communication across teams and departments.

Quality & Compliance

• Ensure compliance with Medicare, Medicaid, HIPAA, and Commercial Payer guidelines.

• Maintain high standards of quality and accuracy across all processes.

• Support internal audits and compliance initiatives.

• Drive process adherence and continuous quality improvement initiatives.

EDUCATIONAL QUALIFICATIONS

• Graduate in any discipline

• Preferred:

o Healthcare Management

o Business Administration

o Relevant certifications in Revenue Cycle Management

DESIRED CANDIDATE PROFILE

• 4–8 years of experience in US Healthcare Revenue Cycle Management.

• Minimum 3–5 years of experience in DME Billing and Accounts Receivable Operations.

• Prior experience as a Subject Matter Expert (SME), Senior Executive, or Team Lead preferred.

• Strong expertise in:

o DME Billing

o AR Follow-up

o Denial Management

o Appeals & Reconsiderations

o Medicare & Medicaid Billing

o Commercial Insurance Billing

o Revenue Recovery

• Experience managing teams of 10–25 FTEs.

• Strong understanding of payer guidelines and DME reimbursement processes.

• Excellent communication, analytical, and problem-solving skills.

• Ability to manage team performance in a target-driven environment.

KEY COMPETENCIES

• DME Billing Operations

• Accounts Receivable Management

• Denial & Appeals Management

• Team Leadership

• Productivity Management

• Client Coordination

• Medicare & Medicaid Expertise

• Commercial Payer Knowledge

• Process Improvement

• Quality Management

• Stakeholder Management

• Coaching & Mentoring

• Performance Management

• Operational Excellence

• Communication & Interpersonal Skills