About the role
Job Summary
The Payer Correspondence Team Leader is responsible for overseeing the daily operations of the payer Correspondence, Patient Accounts and Front-End Services team, ensuring timely review, analysis, and resolution of insurance payer communications related to claims, denials, appeals, refunds, requests for information, and payment disputes. Patient Accounts and FES WQ’s are reviewed and ensured the team is completing them within TAT, timely reporting of daily & weekly activities. The role involves managing team performance, driving productivity and quality, ensuring compliance with payer requirements, and collaborating with internal stakeholders.
Key Responsibilities
Team Leadership
- Monitor daily workloads and allocate resources to meet operational goals.
- Conduct regular performance reviews, feedback sessions, and coaching activities.
- Identify training needs and ensure continuous skill development.
Management
- Oversee the review, categorization, and processing of daily work plans for all the 3 departments.
- Ensure timely action on denial letters, appeals responses, medical record requests, refund requests, recoupments, and other payer communications.
- Prioritize high-impact correspondence affecting cash flow and aging accounts.
- Monitor correspondence-related KPIs and drive resolution of outstanding accounts.
- Escalate complex payer issues and identify root causes of recurring denials.
- Conduct quality audits and implement corrective action plans.
- Maintain documentation standards and reporting accuracy.
Reporting & Analytics
- Track productivity, turnaround time, aging, and quality scores.
- Prepare daily, weekly, and monthly operational reports.
- Analyze trends and recommend process improvements to enhance efficiency and reimbursement.
Process Improvement
- Develop and implement best practices.
- Participate in process optimization initiatives and automation projects.
- Support transition, cross-training, and continuous improvement activities.
Requirements
Required Qualifications
- Any bachelor’s degree
- 4+ years of experience in Healthcare Revenue Cycle Management, min 1 year with Nimble.
- Currently on a Sr Associate or SME.
- Strong knowledge of insurance claims processing, denials, appeals, and payer correspondence workflows, and thorough knowledge of patient accounts and front-end services.
Required Skills
- Team leadership and people management
- Analytical and problem-solving skills
- Strong communication and stakeholder management
- Revenue cycle and payer process knowledge
- Performance management and coaching
- Time management and prioritization
- Data analysis and reporting
- Process improvement mindset
- SLA adherence
- Team engagement and retention