Revenue Cycle Manager

· Will be accountable for working closely with healthcare partners surrounding all billing and insurance processes and provide appropriate oversight and feedback to the higher management that ensures continued success in the revenue cycle management and recommend proposed solutions as required.

· Maintain a detailed understanding of healthcare billing accounts and the ability to work from entry to payment.

· Planning and supervising the day-to-day activities of the insurance department.

· Streamlining processes wherever possible.

· Supervise the submission and resubmission of claims to DHPO/Riayati as per insurance guidelines within the turnaround time.

· Coordinating for reconciliation and sign off with the insurance companies.

· Responsible for new empanelment of branches, network addition, service addition, etc. as required with insurance companies.

· Maintaining the Aging Report and discussing with the higher management when needed.

· Monitor for any leakages and reporting to the higher management.

· Following up on delayed payments with insurance companies as per the Aging Report.

· Monitoring and researching the denied claims and ensuring to work closely with the insurance personnel to bring down the denial rates at acceptable levels.

· Ability to prepare reports based on Submission/RA files.

· To clarify the queries of insurance companies, doctors, nurses and other staff regarding insurance and direct billing, if any.

· Proactively report critical issues to management and submit weekly and monthly reports to the higher management.

· Participating in meetings internally and externally when required

· Must have basic knowledge of ICD-10 and CPT coding.

· Experience with revenue cycle monitoring and reporting for a medical practice or group practice.

Deep understanding of medical coding, billing processes and associated terminology, and regulations as per health regulations guidelines.

Work Location: In person