Assistant Manager

Location: Mohali

Job Description:

Assistant/Deputy Manager – US Medical Billing (Authorization / Practice Excellence)

Position Overview
The Assistant/Deputy Manager – US Medical Billing (Authorizations) is a key leadership role responsible for overseeing end-to-end  Insurance Authorization and Referral processes  within the Revenue Cycle Management (RCM) framework. This role involves managing client relationships, ensuring accurate and timely authorizations, and coordinating across internal teams to deliver high-quality outcomes. The position requires strong expertise in US healthcare authorizations, excellent communication skills, and proven leadership experience.

Key Responsibilities
1. Client Management and Communication
Act as the primary point of contact for clients regarding  authorization-related workflows .
Manage and respond to client queries promptly, providing clear resolutions or status updates on authorization cases.
Schedule and lead weekly/monthly client meetings to discuss authorization TAT, denials, pending cases, and payer-specific challenges.
Gather client feedback and share insights with internal teams to improve authorization accuracy and turnaround time.
Perform deep dives and account-level reviews to ensure authorization work quality, compliance, and adherence to client requirements.
2. Cross-Department Coordination
Coordinate closely with Scheduling, Front Office, Coding, Billing, and AR teams to ensure seamless authorization flow.
Set clear expectations with internal teams for authorization SLAs, payer guidelines, and client-specific protocols.
Ensure timely and accurate completion of prior authorizations, referrals, and eligibility checks.
Facilitate collaboration to resolve issues impacting patient access, claim denials, and client satisfaction.

3. Performance Monitoring and Process Improvement
Monitor authorization performance metrics such as TAT, approval rates, pending volumes, and denial trends.
Identify gaps in payer requirements, documentation, or workflows and recommend corrective actions.
Drive continuous process improvement initiatives to enhance efficiency and reduce authorization-related denials.

4. Authorization & RCM Expertise
Demonstrate strong knowledge of  US Insurance Authorizations , including:
Prior Authorizations
Referrals
Eligibility & Benefits Verification
Payer Portals and IVR Systems
Medical Necessity and Clinical Documentation Requirements
Understand downstream impacts of authorization on Claims, AR, and Patient Billing.
Stay updated with payer policy changes, LCD/NCD guidelines, and industry best practices.

5. Leadership and Team Management
Lead and mentor authorization teams, ensuring productivity, quality, and compliance.
Foster a culture of accountability, collaboration, and client-centric service.
Proactively address escalations and ensure consistent client satisfaction through strategic planning and issue resolution.

Qualifications
Must be a graduate in any stream.

Experience
Minimum  8 years of experience  in US Healthcare RCM with a strong focus on  Authorizations / Referrals .
At least  3–4 years of leadership experience  managing authorization teams.
Minimum  2 years of direct client communication experience  with Physicians and/or their Front Office
(No third-party CRM or intermediary communication experience will be considered) .

Preferred Skills
Ability to manage multiple clients and authorization workflows simultaneously.
Strong analytical skills to interpret authorization performance data and identify improvement areas.
In-depth knowledge of US healthcare payer policies and compliance standards.
Excellent communication, negotiation, and stakeholder management skills.
Strong problem-solving abilities with a patient-access and client-focused mindset.