Role & responsibilities

- Lead and manage a team handling Pre-Authorization initiation, follow-up, status verification, and authorization-related voice processes with insurance companies and TPAs.

- Ensure the team consistently meets defined quality, productivity, SLA, turnaround time, and compliance targets.

- Monitor and evaluate authorization calls to ensure accurate verification of insurance eligibility, advantages, authorization requirements, payer guidelines, and client-specific processes.

- Ensure associates follow established SOPs, quality parameters, compliance requirements, and client guidelines while handling authorization cases.

- Conduct regular call audits, transaction audits, and process reviews to identify errors, gaps, and opportunities for improvement.

- Provide timely and structured feedback, coaching, and performance improvement plans to team members based on quality and productivity outcomes.

- Monitor authorization cases for accurate documentation, timely follow-ups, proper status updates, and complete case notes in healthcare systems.

- Ensure accurate and effective communication between providers, insurance companies/TPAs, internal teams, and other stakeholders.





- Handle and resolve complex, delayed, and escalated authorization cases, ensuring appropriate follow-up and timely closure.

- Track team performance through quality scores, productivity metrics, error trends, SLA adherence, attendance, and other operational KPIs.

- Prepare and maintain quality reports, error trackers, performance dashboards, RCA reports, and management reports.

- Analyze recurring errors and conduct Root Cause Analysis (RCA) to identify process, knowledge, communication, or system-related gaps.

- Drive Corrective and Preventive Actions (CAPA) and process improvement initiatives to improve accuracy, productivity, turnaround time, and customer/client satisfaction.

- Conduct regular calibration sessions with Quality, Operations, Training, and other relevant teams to ensure consistent interpretation and application of quality parameters.

- Partner with the Training and Quality teams to

Preferred candidate profile

- Minimum 6 + Years of experience into Pre Authorization(Semi Voice Process)

- And also minimum 6 months of experience as Team Lead on Papers

📌 Pre Authorization - Team Coach & Team Lead (Hyderabad)
🏢 Talentboon Consulting
📍 Hyderabad