Team Lead, Denial Management (India) at Commure

Gurugram, Haryana, India

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Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Hands-on experience across both inpatient and outpatient denials
Experience driving overturns, reducing aged inventory, and preventing recurrence at the root cause

Responsibilities

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

Skills

Key technologies and capabilities for this role

Denial ManagementTeam LeadershipInpatient DenialsOutpatient DenialsRevenue Cycle ManagementRoot Cause AnalysisCoding CollaborationCharge EntryRegistrationPayer Relations

Questions & Answers

Common questions about this position

What is the employment type for this Team Lead position?

This is a full-time position.

Is this role remote or based in a specific location?

This information is not specified in the job description.

What skills and experience are required for the Denials Team Lead role?

Hands-on experience across both inpatient and outpatient denials is required, along with skills in reviewing EOB/ERA, CARC/RARC codes, payer policies, medical necessity criteria, and knowledge of common IP/OP denial reasons like level of care, DRG changes, bundling, NCCI edits, and prior auth.

What is the company culture like at Commure?

Commure has a mission-driven culture focused on simplifying healthcare through AI innovations, with bold ambitions, rapid growth, and a collaborative environment tackling industry challenges.

What makes a strong candidate for this Team Lead role?

A strong candidate has hands-on experience in inpatient and outpatient denials, proven team leadership skills including coaching and performance management, and expertise in denials resolution, root-cause analysis, and collaboration with cross-functional teams like Coding and Payer Relations.

Commure

Healthcare technology for data integration and safety

About Commure

Commure focuses on improving the healthcare industry by providing technology solutions that connect and empower healthcare workers. Its main product, CommureOS, is a lightweight operating system that integrates various healthcare technologies and datasets, helping providers streamline workflows and enhance patient care by delivering critical insights when needed. Additionally, Commure offers Commure Strongline, a discreet wearable badge that allows healthcare staff to quickly call for help, improving safety in potentially dangerous situations. This badge was developed with input from frontline workers and security experts to meet the specific needs of healthcare environments. Commure serves hospitals, clinics, and other healthcare facilities through a software-as-a-service (SaaS) model, charging subscription fees for access to its products. The company's goal is to create a more connected and safe healthcare ecosystem, ultimately enabling healthcare providers to deliver better care.

San Francisco, CaliforniaHeadquarters

2017Year Founded

$745.2MTotal Funding

GROWTH_EQUITY_VCCompany Stage

Enterprise Software, HealthcareIndustries

201-500Employees

Benefits

Unlimited Paid Time Off

Health Insurance

Dental Insurance

Vision Insurance

Parental Leave

Risks

Increased competition in AI scribe technology may pressure market share and pricing.

Integration of Memora Health's platform may face alignment challenges with existing systems.

Free AI scribe offering might strain resources if not monetized effectively.

Differentiation

CommureOS integrates disparate healthcare datasets, enhancing decision-making and operational efficiency.

Commure Strongline badge improves staff safety with rapid emergency alerts.

Commure's AI-powered scribe tool automates documentation, saving providers significant time.

Upsides

Acquisition of Augmedix enhances AI medical documentation, improving clinical decision-making.

Merger with Athelas creates a $6B healthcare infrastructure company, expanding resources.

Free AI scribe tool offers competitive advantage by broadening technology accessibility.

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