Team Manager- RCM

2 weeks ago

Mohali, India Indihire Consultants Full time

Role & responsibilities

Key Responsibilities:

  • Lead and manage a team of specialists handling Eligibility & Benefits Verification and Prior Authorization.
  • Oversee day-to-day operations, ensuring SLAs, quality standards, and productivity targets are met.
  • Review and analyze authorization and eligibility data to identify trends, gaps, and opportunities for process improvement.
  • Ensure timely verification of insurance coverage, benefit details, and preauthorization requirements.
  • Liaise with insurance payers and provider offices to resolve complex authorization or eligibility issues.
  • Implement and maintain standard operating procedures (SOPs) in compliance with payer requirements and HIPAA regulations.
  • Provide coaching, training, and performance feedback to team members regularly.
  • Collaborate with internal teams including patient access, billing, and coding to ensure clean claim submissions.
  • Monitor and report on key performance indicators (KPIs) and provide regular updates to senior leadership.
  • Handle escalations related to payer communications, patient inquiries, or team performance.
  • Stay current with industry regulations, payer policy changes, and best practices.

Preferred candidate profile

  • Bachelors degree in Healthcare Administration, Business, or a related field (preferred).
  • Minimum of 5+ years experience in Revenue Cycle Management with at least 2 years in a leadership or supervisory role.
  • Strong knowledge of U.S. healthcare insurance, including Medicare, Medicaid, and commercial payers.
  • In-depth experience in Eligibility & Benefits Verification (EVBV) and Prior Authorization workflows.
  • Proficient in EHR/RCM systems (e.g., Epic, Cerner, eClinicalWorks, Athenahealth, etc.).
  • Excellent communication, leadership, and problem-solving skills.
  • Ability to analyze data and generate actionable insights.
  • Strong understanding of HIPAA and other healthcare compliance standards

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