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SENIOR ADVANCED BILLING AND CLAIMS REPRESENTATIVE.

Job Title

SENIOR ADVANCED BILLING AND CLAIMS REPRESENTATIVE.

Job Family

Function

CFO

Job Code

30008793

Reports to Job

Business Unit Lead

Job Description Summary

The Senior Advanced Billing and Claims Representative is responsible for overseeing and optimizing the credit and collections processes within a healthcare organization. This role involves but not limited to : managing patient accounts and insurance claims, developing effective collection strategies, and ensuring compliance with healthcare regulations. The Specialist will lead a team, resolve complex billing issues, and collaborate with various departments to improve overall financial performance and operational efficiency.

Strategic Roles & Responsibilities %

30

Strategic Roles & Responsibilities

  • Provides guidance and strategic oversight on all billing and claimsrelated matters by developing strategies to optimize billing processes ensuring regulatory compliance Works in conjunction with the RCM auditors and Internal Auditors to fulfill any audit and compliance obligationsDevelop and review policies and procedures

Operational Roles & Responsibilities %

70

Operational Roles & Responsibilities

  • Maintain records of accounts and balances identifying discrepancies and generating invoices receipts and bills for all bills Dental and Medical
  • Prepare and present regular departmental reports and performance metrics to senior management for decision making and performance review
  • Monitor audit claims process and support any service charges recommended to the clinical teams and process claim supporting documentation
  • Update billing systems with the latest claim information corrections and adjustments to ensure data accuracy and consistency
  • Analyze current workflows identify bottlenecks or inefficiencies and suggest actionable changes
  • Engage and support in responding to inquiries from insurance companies and payers related to complex individual patientscases and review incoming and outgoing documents related to invoices and payments

Minimum Education Required

Bachelor's degree in Business Administration, Finance, or related field, or Master’s degree in relevant field with 7 10 years of experience

Professional Certifications Required

(Certification in revenue cycle management or case management is preferred)

Years of Experience

Minimum 13 years' in billing and claims management, with significant experience in a strategic or advisory role

Languages

English:Fully Proficient ; Arabic:Basic

Functional Competencies

  • Due Diligence
  • Audit Reporting
  • Data Collection

Core Competencies

  • Excellence
  • Integrity
  • Accountability
  • Cybersecurity
  • Person-Centered Care

Acknowledgement

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Addendum Title

No

Supplemental Work/Experience/Education Information

N/A

Addendum Description

N/A

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