POSITION SUMMARY

Reporting to the Finance Director, the Revenue Assurance Manager plays a crucial role in managing and maximizing the hospital’s revenue cycle by ensuring accurate billing, claims processing, collections, and financial reporting. This position requires a blend of financial acumen, client relationship management expertise, and a basic understanding of clinical processes and interfaces with the Financial Controller, Admission & Discharge Officers, Credit Controller, Client Services, and Credit Controller. The role will oversee a team responsible for revenue accounting, claims, admissions, and receivables, ensuring a seamless flow of financial operations.

ACCOUNTABILITIES

• Revenue Cycle Management
• Oversee the end-to-end hospital revenue cycle, including patient admissions, billing, claims, collections, and reporting.
• Ensure compliance with hospital policies and regulatory standards.
• Claims and Insurance Management
• Manage relationships with insurance providers to ensure prompt and accurate claim settlements.
• Monitor claim submissions, follow-ups, and rejections to improve turnaround time.

Team Leadership

• Supervise and guide the Revenue Accountant, Claims and Dispatch Officers, and Admission & Dispatch Officer Assistant.
• Provide regular training and mentoring to enhance the team’s performance and knowledge.

Reporting and Analysis

• Monitor revenue trends and provide insights to senior management for informed decision-making.
• Develop and track key performance indicators (KPIs) for financial health and efficiency.

Client Relationship Management

• as a liaison between the hospital, patients, and insurance companies, leveraging prior banking or insurance experience to build trust and resolve issues promptly.
• Handle escalations and resolve disputes related to billing or claims professionally.

Admission and Billing Oversight

• Ensure accurate and efficient patient admission and billing processes.
• Collaborate with clinical teams to ensure proper documentation for seamless claims processing.

Audit and Compliance

• Conduct regular audits of financial records to ensure accuracy and transparency. Stay updated on healthcare regulations and insurance policies to ensure adherence.

TYPE & AMOUNT OF EXPERIENCE

• Bachelor's degree in finance, Accounting, Business Administration, or related field.
• Minimum of 5 years of experience in a managerial role, preferably in a banking industry or insurance company. Clinical/Medical background is an added advantage.
• Ability to analyze and interpret business and financial reports effectively and communicate with stakeholders.
• Proficiency in financial software, health management information systems and revenue cycle management systems.

TECHNICAL COMPETENCIES:

• Analytical and Detail-Oriented: Demonstrates a high level of attention to detail, especially in financial and clinical data analysis. Capable of dissecting complex information to uncover insights related to revenue assurance and compliance.
• Strategic Problem Solver: Displays a proactive approach to identifying issues, particularly in revenue leakage, billing discrepancies, and compliance gaps, and devises sustainable solutions in collaboration with cross-functional teams.
• Ethical and Accountable: Maintains a high standard of integrity and accountability, particularly when handling sensitive financial information and interacting with multiple departments to ensure transparency and trustworthiness in revenue management.