QA Manager - RCM Operations
ACCUMED, United Arab Emirates

Primary Responsibilities:

• Collaborate with internal RCM and billing departments to ensure we’re meeting payer requirements and assist in the quality assurance review process.
• Provide monthly reports on current volume, status and outcomes of both completed and outstanding appointments that are in the QA team work queues.
• Assist in reducing rejections from insurance companies to be the minimum ratio and ensure the claims submitted are perfect as per the DHA/HAAD guidelines
• Serve as a customer contact on quality issues.
• Train employees in the analysis of basic causes of customer complaints and returns, and participate in initiating corrective action.
• Create work instructions and operating procedures for new or changed processes, as well as rework instructions for non-standard operations.
• Recommends improvements in insurance processing, which will reduce reimbursement turnaround time
• Researches denied and improperly processed claims by contacting assigned carriers to ensure proper processing of said claims
• Identifies and corrects any claim processing (data entry, verification, coding, resubmission and/or posting) errors
• Participates in weekly meetings as requested

Other duties as assigned

Qualifications/Experience/Skills/Knowledge required for this role:

• Certified Coder
• Bachelor’s degree in Graduate Degree in Management with experience in Healthcare Insurance and Revenue Cycle Management. (In some cases, an advanced degree may be desirable)
• Minimum 5+ years’ experience in a similar role, GCC exposure will be an added advantage, Excellent relationship with all major insurance companies.
• Experience in RCM Process, clinic amp; Hospital operations
• Proficiency in utilizing and interpreting financial models and analysis

• Ability to systematically analyze complex problems, draw relevant conclusions and implement appropriate solution
• Strong verbal and written skills, and ability to convey complex information in a way that others can readily follow

Job Rewards and Benefits