Revenue Assurance Manager

Location: Valley Hospital, Nakuru County
Application Deadline: January 6, 2025
Interview Period: November 18, 2024 – January 24, 2025

About Rise & Learn Global
Rise & Learn Global is a Human Resource Solutions Organization focused on making an impact by developing world-class leaders through HR Outsourcing, Consulting, Coaching, Training, and Youth Empowerment programs. For more details, visit www.riseandlearn.ke.

About the Client – Valley Hospital
Valley Hospital, located in Nakuru County, is a premier healthcare facility committed to providing quality and affordable healthcare. The hospital offers a broad range of services, from private consultations and small clinics to emergency care, and continuously strives for innovation and excellence in patient care. The hospital is currently seeking a Revenue Assurance Manager to join its finance team.

Position Summary
Reporting to the Finance Director, the Revenue Assurance Manager will manage and maximize the hospital’s revenue cycle, including billing, claims processing, collections, and financial reporting. The role requires a combination of financial expertise, client relationship management, and a basic understanding of clinical processes. The Revenue Assurance Manager will work closely with the Finance Director, Admission & Discharge Officers, Credit Controller, and other team members to oversee revenue accounting, claims, admissions, and receivables.

Key Responsibilities

1. Revenue Cycle Management

   • Oversee the complete revenue cycle, including patient admissions, billing, claims, collections, and financial reporting.

   • Ensure compliance with hospital policies, industry standards, and regulatory requirements.

2. Claims and Insurance Management

   • Manage relationships with insurance providers to ensure accurate and timely claim settlements.

   • Monitor claims submissions, follow-ups, and rejections to improve the turnaround time.

3. Team Leadership

   • Supervise the Revenue Accountant, Claims and Dispatch Officers, and Admission & Dispatch Officer Assistant.

   • Provide regular training and mentoring to enhance team performance and knowledge.

4. Reporting and Analysis

   • Monitor revenue trends and provide insights to senior management for strategic decision-making.

   • Develop and track key performance indicators (KPIs) to monitor financial health and efficiency.

5. Client Relationship Management

   • Act as a liaison between the hospital, patients, and insurance companies, using prior banking or insurance experience to build trust and resolve issues.

   • Handle escalations and resolve disputes related to billing or claims.

6. Admission and Billing Oversight

   • Ensure the accuracy and efficiency of patient admission and billing processes.

   • Collaborate with clinical teams to ensure proper documentation for seamless claims processing.

7. Audit and Compliance

   • Conduct regular audits of financial records to ensure accuracy and transparency.

   • Stay updated on healthcare regulations and insurance policies to ensure adherence.

Qualifications & Experience

• Education: Bachelor’s degree in Finance, Accounting, Business Administration, or a related field.

• Experience: At least 5 years of managerial experience, preferably in a banking or insurance company. A clinical/medical background is a plus.

• Skills: Ability to analyze and interpret financial reports and communicate effectively with stakeholders.

• Technical Competencies: Proficiency in financial software, health management information systems, and revenue cycle management systems.

Desired Competencies

• Analytical and Detail-Oriented: Demonstrates a high level of attention to detail, especially in financial and clinical data analysis.

• Strategic Problem Solver: Proactively identifies issues and collaborates with teams to create sustainable solutions for revenue leakage and billing discrepancies.

• Ethical and Accountable: Maintains integrity and accountability in handling sensitive financial information.

Behavioral Competencies

• Effective Communicator: Strong written and verbal communication skills, able to articulate findings and strategies clearly.

• Adaptable and Resilient: Ability to adapt to evolving healthcare regulations and revenue cycle processes while maintaining focus under pressure.

• Team-Oriented Leader: Works collaboratively with cross-functional teams to enhance revenue cycle improvements and create a cohesive work environment.

Work Environment

• On-site work model at Valley Hospital, Nakuru County.

• Standard office conditions.

Equal Opportunity Employer
Valley Hospital is an equal-opportunity employer and encourages applicants from diverse backgrounds to apply.

How to Apply
Interested applicants should submit their applications online by January 6, 2025, by 5 PM. To apply, visit the following link: Apply Now.

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