Revenue Management Specialist - RCM
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Key skills for this role
About the Role
JAL International Co. Ltd. seeks a Finance & Revenue Cycle Management Specialist to oversee financial, collection, and insurance claim activities in a healthcare environment.
Key Skills for This Role
Responsibilities
- Review and validate all invoices submitted by service providers for accuracy, completeness, and contractual compliance
- Oversee the monthly insurance claim submission process across multiple insurance providers
- Validate claim accuracy, completeness, and compliance with insurer requirements
- Monitor claim rejection rates and implement corrective action plans to reduce denials
- Lead reconciliation meetings with insurers and service providers to resolve payment discrepancies
- Prepare monthly financial analysis and variance reports, including recommendations for corrective actions
- Ensure timely collection and reconciliation of accrued revenue and accounts payable
- Monitor CAPEX and OPEX allocation to ensure projects are executed within approved budgets
- Prepare and present financial and insurance performance reports to senior management
- Serve as primary point of contact for financial and insurance related matters with insurers and service providers
Requirements
- Bachelor's Degree in Finance, Accounting, or related field
- Minimum 6 years of relevant experience
- At least 3 years in a lead or supervisory role
- Proven experience in healthcare finance, insurance operations, or revenue cycle management
- Strong experience in budgeting, financial planning, forecasting, and financial reporting
- Hands on experience with insurance claims processing, validation, reconciliation, and collections
- Advanced Microsoft Excel skills including Pivot Tables, VLOOKUP/XLOOKUP, Advanced Formulas, Financial Modeling, Data Analysis and Reporting
- Strong analytical and financial management skills
- High attention to detail
- Strong negotiation, communication, and stakeholder management skills
Full Job Posting
Position Summary
- The Finance & Revenue Cycle Management (RCM) Specialist will oversee and manage all financial, collection, and insurance claim activities within a healthcare environment.
- This role is responsible for ensuring accurate, timely, and transparent validation of invoices, submissions, payments, collections, quotations, and insurance claims across healthcare providers and insurers.
Key Responsibilities
- Review and validate all invoices submitted by service providers for accuracy, completeness, and contractual compliance.
- Review and validate quotations for services and ensure alignment with approved contractual terms.
- Collaborate with Finance and leadership teams on budget adherence, forecasting, and expenditure control.
- Lead the preparation, monitoring, and management of annual budgets in alignment with organizational strategic and operational goals.
- Prepare monthly financial analysis and variance reports, including recommendations for corrective actions.
- Ensure timely submission and processing of work completion certificates, invoices, and related financial documentation.
- Provide regular updates on operational financial status, including CAPEX, OPEX, contractor payments, insurance payments, governance related expenditures, and accreditation related costs.
- Ensure timely collection and reconciliation of accrued revenue and accounts payable.
- Monitor CAPEX and OPEX allocation to ensure projects and procurement activities are executed within approved budgets and timelines.
- Oversee the monthly insurance claim submission process across multiple insurance providers.
- Validate claim accuracy, completeness, and compliance with insurer requirements.
- Monitor claim rejection rates and implement corrective action plans to reduce denials and improve reimbursement timelines.
Reporting & Analysis
- Prepare and present financial and insurance performance reports to senior management.
- Track and monitor key performance indicators (KPIs) related to finance, revenue cycle management, and collections.
- Identify risks, inefficiencies, and opportunities for revenue optimization and cost control.
- Support decision making through financial modeling, forecasting, and data driven analysis.
Leadership & Stakeholder Management
- Serve as the primary point of contact for financial and insurance related matters with insurers and service providers.
- Work closely with healthcare operations, finance, and leadership teams to align financial and operational objectives.
- Facilitate collaboration among internal and external stakeholders to improve financial performance and revenue cycle efficiency.
- Support internal and external audits and ensure compliance with financial policies, procedures, and regulatory requirements.
Qualifications
- Bachelor's Degree in Finance, Accounting, or a related field (required).
- Master's Degree in Finance, Accounting, Business Administration, or related discipline (preferred).
- Professional certifications: CPA, CMA, ACCA, or CIMA (preferred).
- Minimum 6 years of relevant experience.
- At least 3 years in a lead or supervisory role.
- Proven experience in healthcare finance, insurance operations, or revenue cycle management.
- Strong experience in budgeting, financial planning, forecasting, and financial reporting.
- Hands on experience with insurance claims processing, validation, reconciliation, and collections.
- Demonstrated experience managing healthcare related budgets and financial controls.
Required Competencies
- Strong analytical and financial management skills.
- Advanced knowledge of healthcare insurance claims and revenue cycle processes.
- High attention to detail with the ability to identify errors, discrepancies, and financial risks.
- Advanced Microsoft Excel skills, including Pivot Tables, VLOOKUP/XLOOKUP, Advanced Formulas, Financial Modeling, Data Analysis and Reporting.
- Strong negotiation, communication, and stakeholder management skills.
- Ability to work effectively with cross functional teams, service providers, and insurance companies.
- Strong problem solving and decision making capabilities.
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