We are seeking an experienced and detail-oriented Revenue Cycle Manager to lead and optimize the full spectrum of our revenue cycle processes. This role is pivotal in ensuring timely and accurate claims submission, minimizing denials, maximizing reimbursements, and maintaining full compliance with UAE healthcare regulations and payer requirements.
The ideal candidate will bring advanced knowledge in medical coding (AAPC certified), have hands-on experience in claims submission and resubmission, and demonstrate proficiency in denial management and appeals. Experience in managed care operations and healthcare billing systems is essential.
Key Responsibilities:- Oversee the entire revenue cycle, including patient registration, charge capture, coding, billing, collections, and reimbursement.
- Supervise and guide the medical coding team to ensure correct and compliant CPT, ICD-10, and HCPCS coding (AAPC or equivalent standards).
- Manage timely and accurate claims submission to all insurance providers and third-party payers.
- Handle denied claims, including thorough analysis, root-cause identification, and resubmission or appeals in accordance with payer-specific guidelines.
- Monitor and audit revenue cycle workflows to identify gaps, delays, or inefficiencies.
- Ensure compliance with local insurance policies (e.g., Daman), DOH billing regulations, and international coding standards.
- Collaborate with clinical, administrative, and finance teams to resolve documentation or coding discrepancies affecting revenue.
- Track and report on key performance indicators (KPIs), including collection rates, denial rates, days in A/R, and other financial metrics.
- Support contract management with insurance companies and managed care organizations.
- Lead continuous improvement initiatives to maximize revenue, reduce denials, and enhance patient satisfaction.
Qualifications:- Proven experience in Revenue Cycle Management within a healthcare setting (UAE experience preferred).
- Strong background in Medical Coding; AAPC or AHIMA certification is highly desirable (e.g., CPC, COC, CCS).
- In-depth knowledge of claims submission, resubmission protocols, and denial management workflows.
- Understanding of Managed Care, payer contract terms, and reimbursement models.
- Familiarity with UAE health insurance systems and regulations, including Daman, DOH, and TASNEEF JAWDA standards.
- Proficient in billing software, healthcare ERP systems, and electronic health records (EHR).
- Excellent analytical, problem-solving, and communication skills.
- Bachelor's degree in Healthcare Administration, Business, or a related field (Master's degree is a plus).
