About this role
Responsible for Analyzing data and producing meaningful insights related to Billing, Coding, Denials and MIS.
Responsible for observing and monitoring revenue, denial and coding performances of an organization with the aim of identifying trends, variances, reforms impact, profits/losses and presenting it in an organized simplified manner. This position is expected to work hand in hand with data analyst and other RCM staff for data gathering, revenue capture and brainstorming ideas to gather insightful deliverables and outcomes for the benefit of the organization.
1. Data Gathering & Analysis
- Analyse large numerical datasets related to hospital revenue, denials, and coding performance, transforming them into clear, understandable reports for executives and decision‑makers.
- Participate in data collection processes and criteria-setting with Data Analysts and RDD staff.
- Identify key data elements essential for strategic decisions and business insights.
- Ensure accuracy through data quality audits and corrective action.
- Maintain strict confidentiality in accordance with facility policies.
- Develop and maintain dashboards and standard reports for revenue, denial trends, CMI/LOS, coding performance, DNFC/DNFB, resubmission status, and more.
- Use data modeling and analytical techniques to create or modify data structures supporting information needs.
- Assist Finance in matching revenues to costs to analyze profitability.
- Conduct revenue variance analysis and breakdown revenue by department, specialty, or service type.
- Perform base rate analysis (e.g., FFS, Per Diem, DRG, Standard Base Rates vs. Hospital Costs).
- Compare actual revenue performance against upcoming reforms.
- Prepare clear reports and presentations for stakeholders.
- Identify operational gaps and opportunities to enhance revenue (e.g., internal denials, waiting time, coding issues).
- Analyze and recommend solutions for revenue optimization or neutralization relative to costs.
- Prepare business cases for new revenue initiatives and measure their impact.
- Assist in reviewing patient billing procedures and financial impact analyses.
- Support strategic planning, priority-setting, and goal formation for the Revenue Cycle Department.
- Collaborate with RDD teams on revenue gap investigations.
- Identify revenue cycle–related risks and develop an annual work plan to address them with RDD.
- Collaborate with leadership and relevant departments to resolve revenue cycle issues.
- Report behavior inconsistent with ethical or legal standards.
- Monitor performance outcomes and ensure alignment with facility goals.
- Assist in identifying training and educational needs related to RCM.
- Serve as a resource for clinical, physician, and revenue cycle teams by providing training and content expertise.
- Ensure departmental alignment with facility strategy through effective communication and guidance.
- Uphold facility values while interacting with internal and external customers.
- Maintain effective working relationships with management, clinicians, and cross‑functional teams.
- Support committees, cross-functional initiatives, and interdepartmental projects.
- Assist Finance with required RDD-related data and analysis.
- Set priorities and goals for staff, providing direction and resolving operational issues.
- Conduct performance appraisals and establish KPIs for team members.
- Promote collaborative teamwork and effective workload management.
- Maintain productivity even during low-volume periods by pursuing proactive improvement initiatives.
- Continuously develop professional skills and knowledge through training and development.
- Participate in department huddles, meetings, DO‑IT projects, and process‑improvement initiatives.
- Comply with SEHA facility policies, procedures, and regulatory requirements.
- Maintain confidentiality of all information.
- Serve as a brand ambassador by promoting high customer service standards.
- Follow Occupational Health & Safety, infection control, and emergency preparedness guidelines.
- Adhere to mentorship and development requirements for UAE Nationals.
- BS in Accounting, Finance, Economics, Business Administration, or Healthcare.
- Healthcare‑related certifications.
- Data Analytics/Data Informatics/IT certifications.
- Coding Certifications/Credentials from AHIMA or AAPC.
- BS in Accounting, Finance, Economics, Business Administration, or Healthcare.
- Healthcare certifications.
- Data analytics certifications.
- AHIMA/AAPC Coding credentials.
- 4–6 years relevant RCM experience in a healthcare facility.
- Minimum 2–3 years in data analytics.
- At least 4 years experience in RCM and coding functions.
- Experience in a large healthcare facility.
- Strong analytical and logical reasoning skills.
- Advanced Excel and BI tools proficiency (Power BI, Qlik, SQL, etc.).
- Strong reporting and system-navigation skills.
- Knowledge of ICD, CPT, and coding logic.
- Understanding of billing rules and best practices in revenue cycle operations.
- Proficiency in English.
- Strong MS Office and computer skills.
- Ability to meet deadlines and manage multiple tasks.
- Proficiency in Arabic.
- Ability to manage multiple issues simultaneously and drive them to resolution.
SEHA is committed to delivering world-class healthcare services using the most advanced diagnostics and systems across its network of public healthcare centers and hospitals in addition to partnering with global leaders in healthcare, including world renowned organizations such as the Mayo Clinic.