About Triple
Triple 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 professionals
- Delivering in-depth training to ensure peak performance
- Offering superior account management for seamless operations
Embrace unparalleled professionalism and efficiency with Triple, where we redefine the essence of remote hiring.
Role Overview
We 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 Vertical
- Leading and scaling a 10–15-member team
- Owning client onboarding and implementation
- Participating in new client meetings
- Translating client expectations into execution frameworks
- Driving performance, quality, and revenue outcomes
You will not just manage operations — you will architect and scale them.
Core Responsibilities
Prior Authorization Category Leadership
- Own the overall performance of the Prior Authorization vertical at Triple
- Ensure SLAs, KPIs, quality benchmarks, and revenue metrics are met
- Drive accountability across the Prior Auth team
- Build scalable SOPs and performance frameworks
New Client Acquisition & Onboarding
This is a critical component of the role.
- Participate in discovery calls and new client meetings
- Understand specialty, payer mix, volume, workflows, and existing pain points
- Conduct operational requirement assessments
- Design customized onboarding and transition plans
- Estimate staffing needs and skill allocation
- Define the training roadmap before go-live
- Oversee the implementation and stabilization phase
- Ensure smooth handoff from sales to operations
You will be the operational brain in client onboarding.
Team Leadership & Capability Building
- Lead and mentor 10–15 remote RCM professionals
- Set clear performance KPIs and output expectations
- Conduct regular audits and feedback reviews
- Create training modules and upskilling programs
- Develop team leads and future managers
- Build a high-accountability, high-performance culture
Client Communication & Relationship Management
- Act as the senior operational point of contact
- Present performance dashboards and insights
- Conduct quarterly business reviews
- Handle escalations with structured resolution plans
- Build long-term trust with US healthcare clients
Compliance & Quality Oversight
- Supervise HEDIS and compliance frameworks
- Ensure HIPAA adherence and payer guideline alignment
- Monitor denial trends and first-pass acceptance rates
- Conduct periodic quality audits
- Maintain documentation standards
Good to Have (Not Mandatory)
- Experience scaling RCM operations from 10 → 50+ team members
- Multi-specialty practice exposure
- Experience in client transitions or new practice setups
Required Qualifications
• 6+ years of US Healthcare RCM Prior Auth experience
• 3+ years in a leadership/managerial role
• Deep understanding of:
Prior Authorization workflows
Medical Billing Lifecycle
• Proven experience managing teams of 15+ members
• Strong analytical and operational planning skills
• Experience participating in client onboarding or implementations
Schedule (US Shifts Only)
- Eastern Time - 6:30 p.m. - 3:30 a.m. IST, Monday - Friday
- Pacific Time - 9:30 p.m. - 6:30 a.m. IST, Monday - Friday
Logistical Requirements
- Quiet and brightly illuminated work environment
- Laptop with a minimum of 8GB RAM, an i5 8th-gen processor
- 720P Webcam and Headset
- A reliable ISP with a minimum speed of 100 Mbps
- Smartphone
