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

Denial Management

Team Leadership

Inpatient Denials

Outpatient Denials

Revenue Cycle Management

Root Cause Analysis

Coding Collaboration

Charge Entry

Registration

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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