Revenue Cycle Manager (Prior Authorization)

About TripleTriple is leading the way in remote work solutions, helping small and medium-sized businesses in North America build highly efficient remote teams for Administration, Customer Service, Accounting, Operations, and back-office roles. Our focus has always been on our Clients, People, and Planet, ensuring our operations contribute positively across these key areas. Distinguished by its rigorous standards, Triple excels in:Selectively recruiting the top 1% of industry professionalsDelivering in-depth training to ensure peak performanceOffering superior account management for seamless operationsEmbrace unparalleled professionalism and efficiency with Triple, where we redefine the essence of remote hiring.Role OverviewWe are hiring a Revenue Cycle Management (RCM) Leader who will function as the Category Head for our Prior Authorization division.This is a high-ownership, high-visibility leadership role responsible for:End-to-end delivery across Prior Auth VerticalLeading and scaling a 10–15-member teamOwning client onboarding and implementationParticipating in new client meetingsTranslating client expectations into execution frameworksDriving performance, quality, and revenue outcomesYou will not just manage operations — you will architect and scale them.Core ResponsibilitiesPrior Authorization Category LeadershipOwn the overall performance of the Prior Authorization vertical at TripleEnsure SLAs, KPIs, quality benchmarks, and revenue metrics are metDrive accountability across the Prior Auth teamBuild scalable SOPs and performance frameworksNew Client Acquisition & OnboardingThis is a critical component of the role.Participate in discovery calls and new client meetingsUnderstand specialty, payer mix, volume, workflows, and existing pain pointsConduct operational requirement assessmentsDesign customized onboarding and transition plansEstimate staffing needs and skill allocationDefine the training roadmap before go-liveOversee the implementation and stabilization phaseEnsure smooth handoff from sales to operationsYou will be the operational brain in client onboarding.Team Leadership & Capability BuildingLead and mentor 10–15 remote RCM professionalsSet clear performance KPIs and output expectationsConduct regular audits and feedback reviewsCreate training modules and upskilling programsDevelop team leads and future managersBuild a high-accountability, high-performance cultureClient Communication & Relationship ManagementAct as the senior operational point of contactPresent performance dashboards and insightsConduct quarterly business reviewsHandle escalations with structured resolution plansBuild long-term trust with US healthcare clientsCompliance & Quality OversightSupervise HEDIS and compliance frameworksEnsure HIPAA adherence and payer guideline alignmentMonitor denial trends and first-pass acceptance ratesConduct periodic quality auditsMaintain documentation standardsGood to Have (Not Mandatory)Experience scaling RCM operations from 10 → 50+ team membersMulti-specialty practice exposureExperience in client transitions or new practice setupsRequired Qualifications• 6+ years of US Healthcare RCM Prior Auth experience• 3+ years in a leadership/managerial role• Deep understanding of:Prior Authorization workflowsMedical Billing lifecycle• Proven experience managing teams of 15+ members• Strong analytical and operational planning skills• Experience participating in client onboarding or implementationsSchedule (US Shifts Only)Eastern Time - 6:30 p.m. - 3:30 a.m. IST, Monday - FridayPacific Time - 9:30 p.m. - 6:30 a.m. IST, Monday - FridayLogistical RequirementsQuiet and brightly illuminated work environmentLaptop with a minimum of 8GB RAM, an i5 8th-gen processor720P Webcam and HeadsetA reliable ISP with a minimum speed of 100 MbpsSmartphone

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