Approval Supervisor (Physician)
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Key skills for this role
About the Role
We are looking for an experienced Approval Supervisor to manage and direct our Medical Approvals section for inpatient and outpatient services. This role ensures timely approvals, compliance with CHI regulations, and leads a team of approval specialists.
Key Skills for This Role
Responsibilities
- Oversee daily approval operations and ensure timely submission of pre authorization requests to funders
- Monitor and manage approval rejections, ensuring accurate resubmission
- Implement quality improvement measures and deliver training to the approvals team
- Prepare and present approval reports and KPIs to RCM management
- Collaborate with clinical, billing, and insurance teams to ensure seamless operations
Requirements
- Degree in Medicine
- 5+ years of experience in medical approvals within the healthcare industry
- 3+ years in an RCM supervisory or management role
- Strong knowledge of CHI regulations, HIS systems, and billing/coding standards
- Excellent leadership, analytical, and communication skills
Full Job Posting
About the Role
- We are looking for an experienced Approval Supervisor to manage and direct our Medical Approvals section for inpatient and outpatient services.
- This role ensures timely approvals, compliance with CHI regulations, and leads a team of approval specialists to support revenue integrity and patient care continuity.
Responsibilities
- Oversee daily approval operations and ensure timely submission of pre authorization requests to funders.
- Monitor and manage approval rejections, ensuring accurate resubmission.
- Implement quality improvement measures and deliver training to the approvals team.
- Prepare and present approval reports and KPIs to RCM management.
- Collaborate with clinical, billing, and insurance teams to ensure seamless operations.
Qualifications
- Degree in Medicine.
- 5+ years of experience in medical approvals within the healthcare industry.
- 3+ years in an RCM supervisory or management role.
- Strong knowledge of CHI regulations, HIS systems, and billing/coding standards.
- Excellent leadership, analytical, and communication skills.
Preferred Certifications
- CCHI Certification
- Medical Coding (CPC / ICD 10)
- RCM Training
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