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Revenue Assurance Manager

Nairobi, Kenya
This Job has Expired
Company Details
Industry: Consulting
Description: Rise & Learn Global is a Leadership & HR Solutions organization committed to transforming lives and amplifying that impact across all areas. We believe in the power of leadership and the potential within every individual and organization to achieve greatness.
Job Description

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.
Education: Degree, Diploma
Employment Type: Full Time

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