وصف الوظيفة
Role Overview
RCM Specialist at Waseel, providing end-to-end Revenue Cycle Management operational support to healthcare providers utilizing Waseel's RCM solutions.
Role Purpose
Manage the complete revenue cycle for healthcare providers, ensure compliance with healthcare regulations and payer requirements, resolve claim-related issues, and collaborate with hospital and internal teams to maximize collections, improve operational efficiency, and deliver high-quality RCM services.
Key Responsibilities
Revenue Cycle Management
- Manage the full Revenue Cycle Management process end-to-end, including registration, eligibility, pre-authorization, charging, coding, billing, claims submission, rejection management, follow-up, and collections.
Compliance & Regulation
- Ensure compliance with healthcare regulations and payer requirements.
- Maintain adherence to CCHI regulations and healthcare insurance compliance standards.
- Ensure alignment with CBAHI requirements and healthcare quality standards.
Claims & Collections
- Resolve claim-related issues.
- Identify root causes of claim rejections and implement corrective actions to improve collections.
- Maximize collections through effective claims management.
Stakeholder Collaboration
- Collaborate with hospital teams and internal teams to optimize revenue cycle performance.
Qualifications & Experience
- Bachelor's degree in Health Informatics, Healthcare Administration, Hospital Management, Business Administration, or Management Information Systems.
- 2–3 years of professional experience.
Skills & Competencies
- Fluent in English (spoken and written).
- Advanced Excel skills and data analysis.
- Strong knowledge of Medical Claims, Billing, and Health Insurance Operations.
- Good knowledge of Hospital Information Systems (HIS) and Claims Management Systems.
- Strong analytical, communication, and problem-solving skills.
- Ability to work effectively with cross-functional teams.
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