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

ECLAT Health Solutions; Navi Mumbai; On-site; INR 1,200,000 - 2,000,000; Full time

Benefits offered by this job

Night Shifts

Location Navi Mumbai

Job summary

Eclat Health Solutions India Pvt Ltd is seeking a Team Lead for Prior Authorization (Hospital Billing Inpatient). The role involves managing inpatient authorization operations, ensuring timely approvals, and maintaining process quality in a US healthcare RCM environment.

The team will focus on supervising inpatient authorization requests, monitoring SLA adherence, and driving continuous improvement while coordinating with insurance payers, hospitals, and internal teams from Navi Mumbai during

Qualifications

• Experience in US Healthcare RCM with emphasis on prior authorization workflows.
• Strong understanding of medical necessity and payer guidelines.
• Proven ability to lead a team and manage performance metrics.

Responsibilities

• Lead inpatient prior authorization team for US Hospital Billing.
• Oversee submissions, approvals, extensions, and status follow-ups with payers.
• Monitor productivity, quality, TAT, and SLA adherence; drive process improvements.

Skills

US Healthcare RCM

Prior Authorization

Team Lead

Communication

Job description

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 - 7893217519)

Email : [e-mail]

Regards

HR Team

Eclat Health Solutions India Pvt ltd