Insurance & Revenue Cycle Officer
1 month ago
**Job Purpose**:
Responsible for managing operations and productivity within the revenue cycle, minimizing financial losses, and ensuring efficient coordination with the Insurance department. This role involves overseeing the reconciliation and recovery of pending payments, conducting medical audits, managing claims and denials, and maintaining compliance with regulatory protocols.
**Responsibilities**:
- Generate and analyze financial reports related to insurance claims, payments, and denials.
- Provide regular updates and insights to management on revenue cycle performance and areas for improvement.
- Ensure compliance with all relevant laws, regulations, and accreditation standards related to insurance billing and revenue cycle management.
- Identify and mitigate risks associated with insurance claims and payments.
- Work closely with clinical teams to ensure accurate documentation and coding for insurance claims.
- Manage relationships with external vendors and service providers related to revenue cycle management.
- Negotiate contracts vendors and service providers and ensure service level agreements are met.
- Assist in the development and management of the revenue cycle department budget.
- Ensure efficient and productive operations to minimize financial loss.
- Coordinate with the Insurance department for empanelment, pricing, and negotiation.
- Oversee the reconciliation and recovery of pending payments from insurance companies.
- Manage resubmissions and minimize claim rejection rates.
- Modify software systems to include necessary fields for prior information.
Ensure system updates are in place for improved functionality and efficiency.
**Knowledge / Education / Skills**:
1. Bachelor’s degree in Finance, Business Administration, Healthcare Management, or a related field
2. Minimum of 5 years of experience in revenue cycle management, medical billing, or a related role
3. Strong understanding of insurance processes, claim management, and medical audits.
4. Proficiency in relevant software and systems for medical billing and revenue cycle management.
5. Excellent communication, negotiation, and interpersonal skills.
6. Strong analytical and problem-solving abilities.
Proficiency in English language, both written and spoken.
**Job Types**: Part-time, Permanent
Pay: AED6,000.00 - AED8,000.00 per month
Expected hours: No more than 27 per week
**Experience**:
- Senior role as Revenue Cycle Officer: 5 years (required)
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