Team Lead - Prior Authorization (Hospital Billing - Inpatient Service)

Greetings from Eclat Health Solutions India Pvt Ltd !!!

Job Title: Team Lead Prior Authorization (Hospital Billing Inpatient Services)

Location: Navi Mumbai

Department: US Healthcare RCM

Job Summary: We are looking for an experienced Team Lead – Prior Authorization to manage inpatient hospital authorization operations, ensure timely authorization approvals, and maintain process quality and productivity.

Key Responsibilities:

• Lead and manage the inpatient prior authorization team in US Hospital Billing.
• Oversee authorization requests, approvals, extensions, and status follow-ups with insurance payers.
• Ensure timely submission of clinical documentation and medical necessity information.
• Coordinate with insurance companies, hospitals, and internal teams to resolve authorization-related issues.
• Monitor team productivity, quality, turnaround time (TAT), and SLA adherence.
• Identify authorization-related denials and implement corrective actions.
• Conduct team huddles, performance reviews, coaching, and process training.
• Prepare daily and monthly performance reports and drive continuous improvement.

Required Skills & Qualifications:

• 7–11 years of experience in US Healthcare RCM, with strong expertise in Prior Authorization.
• Minimum 1–2 years of experience as a Team Lead handling inpatient hospital authorization.
• Strong knowledge of US insurance processes, payer guidelines, medical necessity, and inpatient authorization requirements.
• Experience handling authorization escalations, team performance, and quality metrics.
• Excellent communication, analytical, and team management skills.

Work Location : Navi Mumbai

Shifts : Night Shifts
Contact HR : Vinay (WhatsApp - [phone removed])

Email : [email removed]

Regards

HR Team

Eclat Health Solutions India Pvt ltd