Submission & Resubmission Team Lead

Role Overview

Submission & Resubmission Team Lead at NMC Healthcare. This is a leadership role responsible for managing the submission and resubmission team, ensuring operational excellence, and driving continuous process improvement across claims and submission workflows.

Role Purpose

Lead and manage the Submission & Resubmission team to achieve departmental KPIs while ensuring accuracy, timeliness, and compliance across all submission activities. Drive process improvements, manage team performance, and coordinate cross-functional efforts to resolve submission-related issues and optimize the revenue cycle.

Key Responsibilities

Team Leadership & Development

• Lead, coach, and manage the Submission & Resubmission team to achieve departmental KPIs.
• Conduct quality audits and provide feedback and training to team members.
• Manage workload distribution and resource planning to meet service-level agreements (SLAs).

Operations & Monitoring

• Monitor daily submission and resubmission activities to ensure accuracy and timeliness.
• Review rejected or returned submissions, identify root causes, and implement corrective actions.
• Analyze submission trends, rejection patterns, and team performance metrics.
• Manage workload distribution and resource planning to meet service-level agreements (SLAs).

Process & Compliance

• Develop and maintain standard operating procedures (SOPs) for submission workflows.
• Ensure compliance with company policies, payer/client requirements, and applicable regulations.
• Support system upgrades, process automation, and implementation of new workflows.

Stakeholder Coordination

• Coordinate with internal departments such as Operations, Quality, Billing, Coding, Customer Service, and IT to resolve submission-related issues.

Reporting & Analytics

• Prepare daily, weekly, and monthly operational reports for management.

Process Improvement

• Drive process improvement initiatives to enhance productivity and reduce turnaround time.

Qualifications & Experience

• Bachelor's degree in Business Administration, Healthcare Management, Finance, or a related field.
• 3–5+ years of experience in submission, claims processing, revenue cycle, or related operations.
• At least 1–2 years of team leadership or supervisory experience.
• Experience with claims management or submission systems is preferred.