Assistant Manager, Appeals

Commure

5 - 7 years

4 - 8 Lacs

gurugram

Posted:10 hours ago| Platform:

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Skills Required

administration automation claims coding information security analytical javascript healthcare html operations

Work Mode

Work from Office

Job Type

Full Time

Job Description

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.

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