Assistant Manager, Appeals

2 days ago

Gurugram Haryana, India Commure Full time

At Commure, our mission is to simplify healthcare. We have bold ambitions to reimagine the healthcare experience, setting a new standard for how care is delivered and experienced across the industry. Our growing suite of AI solutions spans ambient AI clinical documentation, provider copilots, autonomous coding, revenue cycle management and more — all designed for providers & administrators to focus on what matters most: providing care.

Healthcare is a $4.5 trillion industry with more than $500 billion spent annually on administrative costs, and Commure is at the heart of transforming it. We power over 500,000 clinicians across hundreds of care sites nationwide - more than $10 billion flows through our systems and we support over 100 million patient interactions. With new product launches on the horizon, expansion into additional care segments, and a bold vision to tackle healthcare's most pressing challenges, our ambition is to move from upstart innovator to the industry standard over the next few years.

Commure was recently named to Fortune’s Future 50 list for 2025 and is backed by world-class investors including General Catalyst, Sequoia, Y Combinator, Lux, Human Capital, 8VC, Greenoaks Capital, Elad Gil, and more. Commure has achieved over 300% year-over-year growth for the past two years and this is only the beginning. Healthcare's moment for AI-powered transformation is here, and we're building the technology to power it. Come join us in shaping the future of healthcare.

**Role Overview**:
**Key Responsibilities**:

- Supervise day-to-day Appeals operations and ensure SLA adherence for Inpatient and Outpatient claims.
- Review and analyse denied claims, identifying root causes and ensuring effective appeal strategies.
- Manage a team of Appeals taskers, providing guidance, coaching, and performance feedback.
- Ensure appeals are drafted and submitted with accurate clinical and administrative justification.
- Monitor productivity and quality benchmarks; implement corrective actions where needed.
- Act as an escalation point for complex appeal cases requiring advanced expertise.
- Track key metrics (turnaround time, success rate, appeal overturn percentage) and report performance to leadership.
- Contribute to process improvements and automation initiatives to enhance efficiency and accuracy.

**Required Qualifications**:

- 5-7 years of RCM experience, with at least 2-3 years in Appeals.
- Strong exposure to both Inpatient and Outpatient Appeals is mandatory.
- Proven experience in managing or leading a team in the RCM domain.
- Strong analytical, problem-solving, and decision-making abilities.
- Excellent communication skills (verbal and written) to coordinate with clients and internal teams.

**Preferred Skills**:

- Prior experience as a Team Lead/Assistant Manager in Appeals within a US RCM company.
- Proficiency with RCM tools, EMR/EHR systems, and payer portals.
- Ability to manage high-volume workflows and prioritise under pressure.

Employees will act in accordance with the organization’s information security policies, to include but not limited to protecting assets from unauthorized access, disclosure, modification, destruction or interference nor execute particular security processes or activities. Employees will report to the information security office any confirmed or potential events or other risks to the organization. Employees will be required to attest to these requirements upon hire and on an annual basis.

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