We are looking for a Finance & Revenue Cycle Management (RCM) Specialist to oversee financial activities and healthcare insurance claim processes.
The ideal candidate must have strong experience in both Finance/Accounting and Medical Insurance/Healthcare Revenue Cycle Management. This role will be responsible for financial analysis, budgeting, invoice and quotation validation, insurance claims, reconciliation, reporting, and coordination with healthcare operators, insurance companies, and internal Finance teams.
Key Responsibilities
Finance & Financial Oversight
- Review and validate invoices and quotations for accuracy and compliance.
- Monitor budgets, expenditure, and financial performance.
- Support annual budget preparation, monitoring, and control.
- Prepare monthly financial analysis and variance reports.
- Identify financial discrepancies, risks, and opportunities for improvement.
Medical Insurance & Revenue Cycle Management
- Oversee monthly medical insurance claim submission processes.
- Review and validate insurance claims for accuracy, completeness, and compliance.
- Monitor claim rejections and denials and support corrective actions.
- Perform insurance claim reconciliation and resolve discrepancies with operators and insurers.
- Monitor payment and collection processes and ensure proper documentation.
- Coordinate with insurance companies and healthcare operators regarding claims and payment issues.
Reporting & Analysis
- Prepare financial and insurance/RCM performance reports for management.
- Monitor financial and revenue cycle KPIs.
- Analyze trends and identify opportunities to improve revenue cycle performance.
- Support audits and ensure compliance with applicable policies and requirements.
Coordination & Collaboration
- Act as a key contact for Finance and medical insurance/claim-related matters.
- Coordinate closely with KAUST Health, Finance, healthcare operators, and insurance companies.
- Participate in reconciliation meetings and follow up on outstanding issues.
- Support management with financial and operational analysis.
Requirements
- Bachelor’s degree in Finance, Accounting, or a related field.
- Minimum 6 years of relevant experience, including at least 3 years in a lead/senior role.
- Strong experience in both Finance/Accounting and Medical Insurance/Healthcare RCM.
- Hands-on experience with medical insurance claims, claim validation, rejection/denial management, and reconciliation.
- Experience in financial analysis, budgeting, invoice validation, and reporting, preferably within a healthcare environment.
- Strong knowledge of healthcare revenue cycle processes.
- Advanced Microsoft Excel skills, including formulas, pivot tables, data analysis, and reporting.
- Strong analytical, communication, negotiation, and problem-solving skills.
- Professional certification such as CPA or CMA is an advantage.
- Master’s degree in Finance or a related field is an advantage.