Healthcare Operations Team Leader

Access Healthcare Services Manila, Inc.; Pasay; On-site; PHP 900,000 - 1,350,000; Full time

Job summary

Access Healthcare Services Manila, Inc. is seeking a Healthcare Group Leader to guide a team supporting US Healthcare Revenue Cycle Management, including Prior Authorization, Medical Billing, and Accounts Receivable.

The role focuses on coaching, performance management, and ensuring operational excellence while maintaining compliance with client and regulatory requirements. The Group Leader will drive productivity, quality, and service-level targets, serving as the primary point of contact for

Qualifications

• Minimum 2–3 years in a US Healthcare BPO or RCM environment.
• At least 1–2 years in supervisory or group-leader role.
• Experience in Prior Authorization, Medical Billing, and Accounts Receivable (AR).

Responsibilities

• Lead, coach, and develop a team of Healthcare Associates to meet performance goals.
• Oversee day-to-day operations across Prior Authorization, Medical Billing, AR, and Cash Posting.
• Monitor queues, attendance, schedules, and workload to meet SLAs.
• Ensure HIPAA, PHI, data privacy, and client compliance; participate in audits.

Skills

Team Leadership

US Healthcare RCM

Prior Authorization

Medical Billing

Accounts Receivable

HIPAA knowledge

Excel

Tools

EMR/EHR

Practice Management Systems

Revenue Cycle Platforms

Job description

The Healthcare Group Leader is responsible for leading a team of healthcare associates supporting US Healthcare Revenue Cycle Management (RCM) operations, including Prior Authorization, Medical Billing, Accounts Receivable (AR).This role is accountable for driving team performance, ensuring operational excellence, maintaining compliance with client and regulatory requirements, and achieving productivity, quality, and service level targets.

The Group Leader serves as the primary point of contact for the team by providing coaching, performance management, and day-to-day operational support while fostering a culture of accountability, continuous improvement, and employee engagement.

Key Responsibilities

Team Leadership & Performance Management

• Lead, coach, mentor, and develop a team of Healthcare Associates to achieve individual and team performance goals.
• Conduct regular coaching sessions, performance reviews, and one-on-one meetings to improve productivity and quality.
• Monitor daily work queues, attendance, schedules, and workload distribution to ensure service level commitments are met.
• Recognize and reward high performance while addressing performance gaps through coaching and action plans.
• Promote employee engagement, teamwork, and a culture of continuous learning.

Operations Management

• Manage day-to-day operations across Prior Authorization, Medical Billing, Accounts Receivable (AR), and Cash Posting functions.
• Ensure compliance with client-specific workflows, standard operating procedures (SOPs), and business requirements.
• Monitor operational metrics and implement corrective actions to improve efficiency and accuracy.
• Support business continuity and ensure timely completion of assigned work.
• Escalate operational issues and recommend solutions to minimize business impact.

Functional Responsibilities

Prior Authorization

• Oversee timely submission and follow-up of prior authorization requests.
• Ensure complete and accurate documentation supporting authorization requests.
• Monitor payer turnaround times and resolve authorization-related issues.

Medical Billing

• Ensure accurate claim creation, validation, and submission.
• Review billing edits and support timely claim resolution.
• Monitor billing accuracy and compliance with payer requirements.

Accounts Receivable (AR)

• Oversee insurance follow-up activities to ensure timely reimbursement.
• Monitor denial trends and support resolution of underpayments, denials, and outstanding balances.
• Drive reduction of aging accounts receivable through effective follow-up strategies.

Quality & Compliance

• Ensure adherence to HIPAA, PHI, data privacy, information security, and client compliance requirements.
• Partner with the Quality team to improve audit scores and reduce process defects.
• Ensure team compliance with organizational policies and healthcare regulations.
• Participate in internal and external audits as required.

Qualifications

• Minimum of 2–3 years of experience in a US Healthcare BPO or Revenue Cycle Management (RCM) environment.
• At least 1–2 years of experience in a supervisory, team lead, or group leader role.
• Demonstrated experience in one or more of the following:
• Prior Authorization
• Medical Billing
• Accounts Receivable (AR)

Knowledge & Skills

• Strong understanding of US Healthcare Revenue Cycle Management (RCM), Prior Authorization, and Medical Billing
• Knowledge of commercial insurance, Medicare, Medicaid, and managed care payer guidelines.
• Familiarity with HIPAA, CMS regulations, and healthcare compliance standards.
• Excellent leadership, coaching, and performance management skills.
• Strong analytical and problem-solving abilities.
• Effective communication and stakeholder management skills.
• Proficiency in Microsoft Office applications, particularly Excel.
• Experience with Electronic Medical Records (EMR/EHR), practice management systems, and revenue cycle platforms.
• Ability to manage multiple priorities in a fast-paced, metrics-driven environment.