Assistant RCM Manager (Corniche Fertility Center)

Role Overview

Assistant RCM Manager at Corniche Fertility Center, SEHA HOSPITALS, based at the Corniche Fertility Center.

Role Purpose

To direct the overall operations of the revenue cycle department, manage staff, facilitate the entire revenue cycle process, and ensure accurate, timely claims processing and collection efforts while maintaining compliance with relevant regulations and standards.

Key Responsibilities

Revenue Cycle Operations & Management

• Direct the overall operations of the revenue department and section, including managing staff and assigning responsibilities.
• Facilitate and coordinate the entire revenue cycle process at the facility.
• Monitor Accounts Receivable and Billing department and section in all aspects of claims processing and collection efforts.
• Monitor follow-up processes on claims not fully paid for timely resolution.
• Participate in revenue cycle and denial management work teams.
• Provide consultative services to facility leadership and employees on all revenue-related matters.

Claims & Insurance Management

• Coordinate discussions between billing clerks and utilization nurses for insurance denial claims resubmission.
• Develop and maintain relationships with insurance carriers to keep the department up to date with all billing and processing requirements from outside payers.
• Supervise and make recommendations for claim adjustments, bad debt provision, and contractual allowances.
• Maintain compliance standards for providing accurate information on all claims.
• Ensure compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.
• Manage billing processes to ensure claim packets are accurate, complete, and submitted timely to the insurance payer.

Accounts Receivable & Collections

• Create and supervise a collection area for collecting balances not received in the ordinary revenue cycle process.
• Review and reconcile bank deposits.
• Manage remittance processing and posting miscellaneous cash to general ledger accounts.
• Maintain appropriate internal controls and safeguards over Accounts Receivable and General Ledger records and collection of cash.

Accounting & Financial Management

• Manage daily entries to the general ledger, reconciling accounts, and ensuring entries are completed for timely month-end close.
• Provide accounting staff with accurate and timely reports of monthly revenue and accounts receivable balances.
• Provide statistical analysis of financial data as needed from a variety of sources including facility management team, HAAD, and SEHA.

Patient Registration & Documentation

• Work closely with registration and admissions department and section to ensure registration of patients follows facility policies and that appropriate documentation is captured for claim processing.

Utilization Review & Care Management

• Monitor Utilization Review department and section to ensure patients are provided appropriate care while monitoring the average length of stay for claims.
• Utilize participative management principles in planning and coordinating patient complex discharge.

Staff Training & Development

• Educate and train professional staff on implementation of policies and procedures relating to revenue cycle.
• Act as a manager to the team; check workload, ensure performance management, day-to-day supervision, training, and orientation of staff.
• Delegate responsibilities appropriate to licensure, education, and experience of staff.
• Act as a preceptor and mentor for staff in the revenue cycle department.
• Actively participate in professional development of self and others.

Process Improvement & Strategic Planning

• Gather, interpret, and use data to identify problems and trends to demonstrate outcomes and cost-effectiveness.
• Evaluate factors related to safety, outcomes, effectiveness, cost, and social impact when developing and implementing practice innovations.
• Utilize evidence-based practice to develop and implement standards of practice that guide practice improvement initiatives.
• Provide support to clients through the development of new programs reflecting best global and regional practices.
• Identify and develop projects and programs that would benefit the facility.
• Work with management, clinical and other departments, and patient accounting staff to improve processes, increase accuracy, create efficiencies, resolve related issues, and achieve the overall goals of the department.

Committee & Leadership Responsibilities

• Act as a seat on committees, panels, and task forces as required.
• Remain involved in operational committees and task forces as appropriate.
• Provide input and guidance on revenue cycle-related matters and on operational decisions impacting facility patients and clients.

General Management & Compliance

• Foster teamwork while ensuring maximum efficiencies are implemented to improve employee compliance and revenue generation for the facility.
• Promote harmonious relations with all staff in and outside the facility on a daily basis.
• Maintain collaborative and effective relationships with other key management personnel and keep abreast of significant economic, social, and technical trends and regulatory guidelines that may influence assigned functions or the facility.

Qualifications & Experience

• Bachelor's Degree in any related field.
• Eight to ten years of relevant progressive experience in a similar role.
• Five years of supervisory experience.
• Desired: Experience in a Fertility Center or IVF clinic within Abu Dhabi Region.