RCM Supervisor – Financial Counselling and Authorization -Financial Counselling and Authorization

JOB DESCRIPTION

Job holder is responsible for oversight of all patient facing financial processes. Ensures adherence to policy and procedures for collecting information and counselling Self-Pay, Motor Vehicle Accident (MVA), THIQA Program, ABM, Sponsor International and non-insured patients at time of service. The job holder is also responsible for insurance verification and precertification services for patients presenting for healthcare services within the hospital.

RESPONSIBILITIES

• Develops continuum of revenue cycle best practices and processes from patient access to collections and revenue recognition.
• Develops and implements new policies, methods and procedures to effectively manage and reduce the patient accounts receivable, maximize collections and reduce bad debt
• Evaluates and implements add on information systems to improve operations and ensure better integration between departments and processes
• Attends meetings and seminars called by the management regarding patient financial services
• Contact physicians, Case Management, and Utilization Review to facilitate the sending of clinical information in support of the authorization to the payer
• Coordinates and works with inpatient accounts for authorization and held responsible for timely notification to payers of the patient’s admission to the facility to protect financial standing
• Contacts insurance companies by phone, fax, or online portal to obtain insurance benefits, eligibility, and authorization information.
• Made available proper data source for authorization process ,TAT and financial counselling daily activities including ABM enrolments.
• Maintains closing all pending authorization, GOP, ABM issue to comply with the claims submission timelines.
• Communicates effectively the customer service philosophy of the facility to the current and prospective employees
• Maintains collaborative and effective relationships with other key management personnel and keeps abreast of significant economic, social and technical trends, and regulatory guidelines, which may influence assigned functions/services and/or the facility
• Maintains strong levels of motivation and leadership in the department; effectively communicating and demonstrating a high level of urgency
• Manages workload of the team to ensure proper utilization, performance management, day to day supervision, training and orientation of the staff
• Ensures effective use of progressive discipline when required with corporate Human Resource collaboration
• Prepares and trains the front desk users, routinely undertaking a training needs analysis and facilitating training on documentation, customer services
• Creates and maintains a plan that addresses the initial and continuing development of team
• Supervises the efficient implementation and use of technology by the team to assist in the smooth and efficient flow of information
  
  
  

Accountabilities

• Collects and maintains estimated liabilities from patients.
• Establishes and takes charge of health insurance benefits, conditions, and requirements by making phone inquiries, and by using eligibility systems and the internet.
• Maintains patients’ employment details and other particulars
  
  
  

Required:

QUALIFICATIONS

• Bachelor's degree or equivalent in Accounting/Finance/Commerce/Business Administration or relevant field OR Diploma in relevant field with 3 years of additional experience
  
  
  

Desired:

• Master's degree or equivalent in Accounting/Finance/Commerce/Business Administration or relevant field
  
  
  

Required:

Specialist Certifications:

• N.A.
  
  
  

Desired:

• Recognized accountancy qualification such as CMA,CPA,ACCA,ACA,CA,CFA or equivalent
  
  
  

Experience:

Required:

• 6-8 years of relevant progressive experience in a similar role with 3 years of supervisory experience Minimum 4 years of medical insurance verification and authorization required;
• 4 years of prior authorization experience in large healthcare, multi integrated network, or third- party medical billing environment
• Experience with insurance terminology is required.
• Experience with managing financial counseling, point of service collections and external vendor relationships related to self-pay receivables is highly preferred;
• Experience with third-party payer requirements, contracts, authorization and payment practices
  
  
  

Desired:

• Experience in a large healthcare facility
  
  
  

ABOUT US

At SSMC, we firmly believe that the human touch is a fundamental part of care. We understand that health care is both an art and a science, running deeper than simply diagnosing and treating those who rely on us. Our SSMC Model of Care puts our patients at the forefront of our purpose and at the heart of everything we do, ensuring that the needs of our patients come first. Every one of our patients receives individualized attention from a multidisciplinary team of experts who collaborate closely to deliver trusted and compassionate care. From the very first point of contact with SSMC, to the moment patients are back home, we ensure speciality-specific care at every stage and in every interaction. As one of the largest tertiary hospitals in the UAE, SSMC provides access to specialist medical treatments and advanced diagnostics, with a commitment to becoming a Destination Medical Center in the UAE and wider region.

ABOUT THE TEAM

About Sheikh Shakhbout Medical City (SSMC)

SSMC is the largest tertiary hospital in the UAE and serves to elevate the provision of health care services in the nation under the mandate of the Abu Dhabi Economic Vision 2030.

Supported by the latest diagnostic and treatment modalities available, SSMC offers care in 44 specialties. A team of locally and internationally trained medical, clinical and admin professionals work seamlessly together, which promotes comprehensive interdisciplinary learning, allowing SSMC to become a leading hub for integrated patient-centric medical services in the region.

As the region’s leading tertiary facility, SSMC has 742 patient beds, 18 operating theatres, and includes a hybrid operating room, 26-bed neonatal intensive care unit, and the UAE’s largest pathology lab.