Senior Executive Manager - Revenue Cycle Operations

Job Description

Revenue Cycle Operation

• Develop and maintain a strategic approach to the revenue cycle that aligns with the broader objectives of Bupa insurance.
• Oversee the collaboration with clinical and administrative departments to ensure a seamless integration between care delivery and insurance processing systems.
• Claims Management: Oversee the claims process to insurance providers, ensuring accuracy and compliance with insurance policies.
• Ensure that all claims, denials, and appeals are efficiently processed, and for resolving billing related issues.
• Lead revenue optimization initiatives for cost management.
• lead metrics and reporting to monitor and improve revenue operations effectiveness.
• Drive smooth integration between clinical services and billing systems.
• Partner providers mangment
• Conduct comprehensive market analysis to identify potential partner providers.
• Negotiate favourable terms in contracts with partner providers.
• Establish and maintain robust relationships with partner providers’ RCM departments.
• Building strategies to ensure continuous improvement in partner performance.
• Ensure having a comprehensive database of partner providers.
• Organize regular meetings and workshops with partner providers.
• Create and monitor KPIs for partner provider performance.
• Work closely with the legal team to ensure compliance in partner contracts.
• Audit and compliance
• Develop and maintain a compliance risk management plan.
• Monitor audit findings with stakeholders and implement corrective actions
• Review and update compliance policies and procedures regularly
• Monitor industry changes and adjust compliance strategies accordingly.

Skills

• Analytical skills
• Project management skills
• Communication skills

Education