Job Description

The

Revenue Cycle Manager

is responsible for overseeing and managing the entire revenue cycle process within a healthcare organization. This role involves optimizing financial and operational processes from patient registration to final payment collection, ensuring that the healthcare facility maintains financial health while complying with Qatar's healthcare regulations.

Responsibilities:

Revenue Cycle Operations Management:

Oversee the complete revenue cycle process, including patient registration, insurance verification, medical coding, billing, claims submission, payment posting, and collections. Ensure that all processes are efficient and compliant with Qatari healthcare regulations.

Billing & Coding Compliance:

Ensure that all billing and coding are accurate, in line with the

Qatar Ministry of Public Health (MOPH)

regulations, and compliant with the ICD-10, CPT, and other international standards. Maintain up-to-date knowledge of coding practices and payer requirements in Qatar.

Claims Management & Denial Resolution:

Manage the submission of claims to insurance companies (both local and international insurers). Oversee the follow-up process for unpaid claims, resolve denials, and ensure timely payments. Implement effective denial management strategies to reduce future claim rejections.

Insurance Coordination:

Oversee the verification of patient insurance details, including eligibility and coverage limits, prior to service delivery. Ensure that pre-authorizations are obtained when necessary and the insurance companies' requirements are followed.

Accounts Receivable (AR) Management:

Supervise the accounts receivable process, working to minimize outstanding balances and ensure a steady cash flow. Monitor aging reports and KPIs such as Days Sales Outstanding (DSO) to ensure financial goals are met.

Team Leadership:

Lead, mentor, and manage the revenue cycle team, including billing, coding, and collections staff. Ensure the team is well-trained, motivated, and working efficiently. Set clear expectations and performance goals.

Compliance & Regulatory Reporting:

Ensure that the organization is in compliance with all local and international regulations regarding billing practices, such as those set by the

Qatar Financial Centre (QFC)

and the

Qatar National Health Insurance Scheme (QNHIS)

. Regularly audit billing and coding practices for compliance with these standards.

Financial Reporting & Data Analysis:

Analyze revenue cycle performance and provide reports to senior management on key metrics such as claim rejection rates, collection trends, aging, and overall cash flow. Recommend process improvements based on findings.

Patient Interaction:

Address patient billing inquiries, explain charges, assist with payment plans, and resolve disputes when necessary. Maintain a customer service-oriented approach while ensuring payment is collected in accordance with policies.

Process Improvement:

Identify inefficiencies and recommend changes to streamline the revenue cycle process. Work closely with IT and other departments to implement technology solutions that improve billing accuracy and reduce cycle times.

Qualifications:

Bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field. 05-07 years of experience in healthcare revenue cycle management, preferably within a healthcare setting in the Middle East or with knowledge of Qatari healthcare systems. Strong understanding of billing, coding, and payment policies in the Qatari healthcare system. Proficiency in healthcare management software (e.g., Epic, Cerner, McKesson) and Electronic Health Records (EHR) systems. Strong leadership and people management skills with a proven ability to mentor and lead a team. Analytical mindset with a focus on improving processes, reducing denials, and optimizing cash flow.
Job Type: Full-time