Revenue Cycle Manager – Healthcare Insurance & RCM
Metro Hospitals & Polyclinics · Muscat
Job description
About the role
The Revenue Cycle Manager will lead and optimise the end‑to‑end healthcare insurance and revenue cycle processes for Metro Hospitals & Polyclinics. This role ensures smooth eligibility checks, pre‑authorisations, claim submissions, denial management and payment reconciliation while driving revenue realisation and compliance.
Key responsibilities
- Oversee eligibility verification, pre‑authorisation, claim filing and denial management.
- Monitor accounts receivable, reconcile payments and ensure timely collections.
- Coordinate with insurers, TPAs and payers to resolve issues and improve turnaround times.
- Lead the RCM team, set KPIs, track performance and report on revenue metrics.
- Identify process gaps, implement corrective actions and drive continuous improvement.
- Ensure compliance with local regulations and hospital policies.
Required profile
- Minimum 3 years of hospital RCM or medical insurance experience.
- Strong hands‑on knowledge of the complete healthcare insurance cycle.
- Familiarity with approvals, claim resubmissions, rejections, payment reconciliation and AR follow‑up.
- Knowledge of Dhamani and Omani healthcare insurance processes.
- Experience managing relationships with insurers, TPAs and payers.
- Analytical mindset with solid reporting and team‑management abilities.
- Proven ability to identify and close process gaps.
- Hospital environment experience is essential.
Required skills
- Dhamani system
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Published 1 month ago
Expires 4 weeks from now
27 views · 0 interested
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Metro Hospitals & Polyclinics
Muscat