Job Description

The Revenue Cycle Manager ensures the efficient and smooth processing of patient billing, pre-authorization, insurance claims and recovery through effective liaising with insurance companies while maximizing patient satisfaction by leading the insurance operations with the objective of streamlining the process.

Responsible for timely insurance claims and pre-authorization processing, overseeing the insurance operations and designing, implementing and training the Day Surgery staff on insurance protocols.

Oversees administration of revenue cycle management of Center.

Manages and negotiates contracts with insurance companies to obtain recognition as a service provider. Liaises with insurance companies regarding eligibility, payments, reconciliations to maximize the profitability of the business. Reviews insurance claims to ensure accuracy as per agreement, prior to dispatch to respective insurance companies. Reconcile all collections received and outstanding receivables against all electronic claims submitted and re-submitted. Proactively reports critical issues to Management and submits monthly aging and other reports to Management. Designs, updates and implements policies, procedures and protocols to ensure efficiency and accuracy in insurance operations. Monitors insurance discounts and rejections and prepares & submits periodic reports to the Finance Manager for review. Ensures that the insurance contracts are up to date on the system. Supervises Front Desk (Registration and Billing), ensures that his/ her teams are courteous and professional in their assistance to patients/ visitors. Oversee the billing (cash & credit) sections. Measures the effectiveness and efficiency of on-going front desk related procedures and coordinates procedural changes. Monitors the registration, billing and pre- authorization activities of outpatient, diagnostics and day surgery. Prepares breakdowns for the invoices as required by insurance companies or patients for reimbursement process. Educates reception, nursing and paramedical staff on insurance protocols, new processes or modifications as notified by insurance companies from time to time Assist in the regular audit conducted by the insurance companies and other regulatory agencies. Resolve issues and respond to any related queries, both internal (i.e. other departments) and external (i.e. regulatory agencies, insurance companies). Interact with IT for any software development or applicable systems that help improve the insurance claim process. Develops the unit budget and ensures departmental operations are effectively conducted within the budget. Communicates to patients regarding their insurance policies, eligibility and entitlements. Coordinates with colleagues and other related departments for smooth running of insurance operations

Experience and Skills Required:

Minimum for 3 to 5 years of Qatar experience in a hospital setting in a similar role (Payer/Provider Experience will be added value).

Preferred Experience:

None

Skills required:

Knowledge on insurance claims and billing process. Knowledge on Qatar laws applicable to insurance legislations. Knowledge on HIS & ERP. Knowledge on Allscripts, myCare, Concept soft & Microsoft Dynamics applications are of added value. Experience in revenue cycle management.

Qualification's

Essential:

Bachelor's degree in Finance or related discipline and master's degree in RCM/MBA/MHA is desirable.

Preferred:

Graduate in Medicine /Life Science or other related medical education. Certified Medical Coder (HIMAA/ AHIMA).
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Job Type: Full-time

Pay: QAR10,000.00 - QAR12,000.00 per month

Application Deadline: 30/08/2025