Riyadh , Saudi Arabia

Posted 1 year ago

ACCUMED

We are the first, too the biggest organization in the Center East to give complete start to finish Income Cycle The board answers for the medical services area. Our vision is to be famous and regarded as the district's reference point in Income Cycle The executives for the medical services area.

Insurance Denial Analyst (Business Rules) – Job Vacancy – Riyadh , Saudi Arabia

ACCUMED – Riyadh , Saudi Arabia

Job Location:- Riyadh , Saudi Arabia

Company:- ACCUMED
Education:- As Mentioned
Nationality:- Any Arab National

Gender:- Male / Female
Number of Vacant Positions:- 1 Vacancies
Salary:- Negotiable

Job Type:- As mentioned
Experience:- 5 – 8 Years

About ACCUMED

We are the first, too the biggest organization in the Center East to give complete start to finish Income Cycle The board answers for the medical services area. Our vision is to be famous and regarded as the district’s reference point in Income Cycle The executives for the medical services area.

Our main goal is to give medical care Income Cycle The executives to committed medical care associations by laying out re-appropriated charging administrations as the arrangement of decision, working mutually with public and confidential areas, empowering and embracing inventive advances and development.

We execute ISO Worldwide Norms pointed toward building and creating productive and powerful strategic approaches, regarding all regulations, responsibilities and adding to Saudi Vision 2030 in medical care area by Working on the quality and effectiveness of wellbeing administrations.

About Accumed

Job – Insurance Denial Analyst (Business Rules)

Job Description:

Role Summary:

Insurance Denial Analyst Chiefly responsible for achieving and maintaining minimum Denial rates by contributing in market payer, regulator protocols and Denial and Bypass trends analysis. This is aim to achieve in collaboration with Business Rules Analyst position being reported to him. Furthermore, reviewing medical records in order to abstract relevant data to support the creation/maintenance of Rules. THYNK Rules will support billing integrity and provide best practice support through working closely with payers, regulators, and healthcare providers revenue cycle departments to resolve coding/billing issues, Investigating and resolving issues and incidents leading to incompliance with regulatory policies or denials with payers in the market of Saudi Arabia.

Primary Responsibilities:

1. Managing Business Rules Analyst and ensuring set targets are achieved.

2. Monthly analysis and review of Remittance reports across all the payers and simultaneous provision of feedback suggesting updates for the Rule engine thereby decreasing denial trends for the clients and maximising remittance output.

3. Monthly analysis and review of Bypass reports and simultaneous provision of input to improve rules. Hence, scrubbing and updating quality of Rule engine (THYNK)and optimizing end user experience.

4. Analysing potential and new client’s remittance reports and protocols.

5. Reviewing different trends of analysis thus contributing to automation of Rules engine.

6. Contributing in strengthening of THYNK as a complete product offered in markets to its clients.

7. Email correspondence and troubleshoot with different departments for rule requests, suggestions, and queries.

Job Qualifications:

1. Minimum 4-5 years’ experience in the said field.

2. Excellent Analytical skills and an eye for detail is a must.

3. Medical Billing knowledge within private healthcare insurance sector required

4. Recognised Professional Certification in Medical Coding highly desirable.

5. Candidate with past working experience with insurance payers background (in leadership/management role) will be preferred.

6. Should be well versed KSA local market regulations like CCHI, Health Council and SEBAHI

7. Excellent verbal/written communication and leadership skills

8. Proficiency in Healthcare Information Systems and Microsoft Office (Word, Excel, PowerPoint, etc.)

9. Bi-lingual Arabic/English preferred

10. Medical training as Doctor/Nurse/Pharmacist is highly desirable

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To apply for this job email your details to rcmcareers@accumed.ae

About The Author

Mohamed Firnas

“🌟 Meet Mohamed Firnas: With over two decades of experience in HR, Mohamed is a trusted advisor known for his strategic insight and compassionate leadership style. He’s committed to creating workplaces where every voice is heard and valued. 💼 Passionate about nurturing talent and driving positive change. Join him on the journey towards building better organizations! #HRProfessional #GulfRegion #Leadership”

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