Team Manager- RCM (Authorization & Eligibility Verification) || Mohali

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