Healthcare Team Leader - Davao Site

Job Summary:

The Team Leader is responsible in overseeing payer follow-up representatives supporting U.S. healthcare revenue cycle operations. This role drives appeal tracking, denial resolution, productivity, and documentation compliance while serving as the primary escalation point for complex payer cases.

Job Description

:• Provides real-time guidance to follow-up representatives during payer calls

.• Assists team members in handling complex payer scenarios and appeal inquiries

.• Monitors workload distribution and ensures timely completion of follow-up tasks

.• Serves as first escalation point for challenging payer interactions

.• Reinforces documentation and workflow standards across the team

.• Reviews urgent appeal deadlines and complex AR follow-up cases

.• Investigates missing appeals, payer discrepancies, short-pays, and overturned determinations

.• Guides representatives on next-level appeal strategies

.• Coordinates escalations with analysts or leadership when required

.• Ensures critical cases are escalated within defined timelines

.• Monitors daily team productivity and outbound call performance

.• Ensures adherence to documentation and call handling standards

.• Conducts case reviews to validate appeal status accuracy

.• Ensures real-time updates within HLS tracking systems

.• Identifies workflow bottlenecks and recommends process improvements

.• Reviews documentation quality for completeness and accuracy

.• Ensures call notes include representative name, reference numbers, appeal status, and financial details

.• Provides coaching to improve documentation accuracy

.• Partners with QA teams to maintain compliance standards

.• Ensures strict adherence to HIPAA and PHI security policies

.• Coaches team members on payer communication and denial handling

.• Supports onboarding and training of new representatives

.• Reinforces accountability for productivity and quality metrics

.• Supports performance improvement initiatives when necessary

.
Qualification

s:• Has knowledge in U.S. healthcare insurance payers (Medicare Advantage, Medicaid MCOs, Commercial

).• Experience reviewing payer documentation and denial determination

s.• Demonstrates strong understanding of appeals lifecycle and denial intelligenc

e.• Demonstrates strong leadership and coaching skill

s.• Demonstrates the ability to manage productivity metrics and documentation accuracy standard

s.• Clear and coherent both written and verbal communication skills in Englis

h.
Screening Criter

ia:• High school diploma or equivale

nt.• Minimum of two (2) years experience in AR follow-up, appeals, or insurance follow-

up.• Minimum of two (2) years of team lead or supervisory experience in healthcare revenue cyc

le.• Experience in using any healthcare tracking syste

ms.• Must have stable employment histo