Contract Management and Data Master Officer

22 فبراير، 2023

0 0 2 دقائق

الوصف الوظيفي

Contract Management and Data Master Officer | Al Futtaim Health | Healthcare

JOB PURPOSE

The purpose of this role is to apply and monitor the accuracy of billing cash and insurance tariff across AFG healthcare facilities.

Allocation of insurance contract on the system with accurate implementation of contractual terms. Ensure closure of all open invoices by all Unit In-Charge and pharmacies. On regular intervals,

Contracting and pricing with insurance companies.

KEY ACCOUNTABILITIES:

Description of the Accountability:

To act as a liaison between RCM and IT to update the agreed price list with agreed discount
Responsible for updating clinics and Day Surgery billing tariff (price updating, plan creation, bill code creation, package creation, cost estimates.
Oversee and monitor correct billing and auditing of day surgery and outpatient claims.
Responsible to monitor and prepare clinics/day case monthly revenue report, unbilled report, credit settlement, advance and consumption report and reconcile it for financial accounting.
Provides support and coordinates with various departments to maintain smooth operational workflow.
Support Team in handling complex cases, resolve customer complaints also communicate and discuss with higher management for any operational issue or improvement in work process.
Communicates with internal and external stakeholders for their billing queries and issues and resolve it for accurate processes of billing transactions
Coordinates and provides regular training to staff with respect to various Billing process, Approval Protocols & Procedures.
Provides appropriate guidance to employee by researching, developing, updating billing policy, procedures, method as per guidelines.
Provide all the needful support as advised by the line manager on the business need.
Gather relevant details and information to describe and properly escalate issues to Managers and higher officials.
Proposing new ideas which assure continuous improvement in the billing processes,
Monitory of surgery and higher value claims accurate billing .
Reconcile facility Unbilled order report (open bills report).
Ability to handle conflicts/Problems and come out with proposal plan to resolve the conflict after sufficient analysis.
Actively involved in software implementation process & also suggest in modification & new improvising change for efficient billing cycle.
Update special packages as per recommended tariff..
Reconciliation of hospital packages (day surgery, Health check-up, and Antenatal packages).
Review hospital revenue report on regular basis and investigate suspicious fraudulent activities and takes active measures
Setting up the system for the new facility, new inclusion of the services etc..

Contracting and Pricing: Contracting & Pricing Officer Role :

Coordinating with insurance companies for empanelment of new facilities.
Proposing and negotiating on tariff for the new service requests with insurance companies.
Addressing concerns related to insurance companies ( portal issues, price issues etc..) and coordinating with insurance companies to solve in a timely manner.

المهارات

QUALIFICATIONS, EXPERIENCE, & SKILLS:

Minimum Qualifications and Knowledge:

B.com/finance Graduate from reputed University or any relevant qualification
Well versed Knowledge of Microsoft applications
Minimum 3+ years’ experience in a similar role.

Job-Specific Skills:

Understanding of medical billing
Ability to work independently or as an active member of a team
Strong computer skills ,knowledge of Electronic Medical Record software; Microsoft Office Suite
Accurate and precise attention to detail

Behavioural Competencies: