Full job description

Job Summary

The RCM Supervisor is responsible for supervising and coordinating the complete revenue cycle process of the medical center, including patient eligibility, insurance approvals, claims submission, resubmission, payment reconciliation, denial management, and collection follow-up.

The role ensures accurate and timely claims processing, effective coordination between reception, clinical departments, insurance coordinators, medical coding, and finance, and compliance with DOH Abu Dhabi and payer requirements. The RCM Supervisor is responsible for monitoring team performance, identifying revenue leakage, reducing claim rejections and denials, and supporting timely collection of the medical center's revenue.

Key Responsibilities1. Revenue Cycle Management

1.1 Supervise the complete revenue cycle from patient registration and eligibility verification through claims submission, payment, reconciliation, and collection.

1.2 Ensure claims are processed and submitted accurately and within payer-defined timelines.

1.3 Monitor pending, rejected, denied, and unpaid claims and ensure timely follow-up.

1.4 Review RCM workflows regularly and identify opportunities to improve efficiency and revenue collection.

1.5 Identify potential revenue leakage and coordinate corrective actions with the concerned departments.

1.6 Ensure proper reconciliation between services provided, claims submitted, payments received, and outstanding balances.

2. Insurance Eligibility & Approvals

2.1 Supervise verification of patient insurance eligibility, coverage, benefits, and applicable limitations.

2.2 Ensure required pre-approvals and authorizations are obtained before providing services whenever applicable.

2.3 Monitor pending authorization requests and ensure appropriate follow-up with insurance companies.

2.4 Support the team in resolving complex eligibility, authorization, and insurance coverage issues.

2.5 Communicate insurance requirements and recurring issues to Reception and concerned clinical departments.

3. Claims Submission & Resubmission

3.1 Ensure claims are reviewed for completeness and accuracy before submission.

3.2 Monitor timely submission of claims to different insurance companies and TPAs.

3.3 Ensure rejected and denied claims are analyzed, corrected, and resubmitted within required timelines.

3.4 Monitor resubmission outcomes and follow up on unresolved claims.

3.5 Ensure appropriate supporting documents are attached when required by the payer.

3.6 Maintain accurate records of submitted, rejected, resubmitted, and paid claims.

4. Denial & Rejection Management

4.1 Analyze claim rejection and denial trends and identify root causes.

4.2 Categorize denials related to eligibility, authorization, coding, documentation, medical necessity, contractual requirements, or other reasons.

4.3 Coordinate corrective actions with Reception, Physicians, Nursing, Physiotherapy, Coding, and other relevant departments.

4.4 Monitor repeated rejection reasons and recommend preventive measures.

4.5 Escalate significant or recurring RCM issues to management.

5. Medical Coding & Documentation Coordination

5.1 Coordinate with the Medical Coder to ensure accurate coding and claims preparation.

5.2 Identify documentation deficiencies affecting coding, billing, or reimbursement and communicate them to the appropriate clinical team.

5.3 Support clarification of coding or payer-related requirements when required.

5.4 Monitor recurring documentation gaps that result in rejected or reduced claims and support corrective action.

6. Payment, Reconciliation & Collection

6.1 Monitor insurance payments, outstanding claims, and accounts receivable.

6.2 Coordinate with Finance regarding received payments and reconciliation.

6.3 Review payment discrepancies, underpayments, non-payments, and deductions.

6.4 Follow up with insurance companies and TPAs regarding outstanding payments.

6.5 Monitor aging reports and prioritize overdue accounts for follow-up.

6.6 Support reconciliation of insurer statements and payment records.

7. RCM Team Supervision

7.1 Supervise Insurance Coordinators, Medical Coders, and other assigned RCM staff.

7.2 Distribute workload and ensure appropriate coverage of daily RCM activities.

7.3 Monitor staff attendance, productivity, accuracy, and performance.

7.4 Provide guidance and support to team members regarding complex cases.

7.5 Conduct or coordinate training related to insurance requirements, claims processes, system updates, and identified performance gaps.

7.6 Promote effective communication and teamwork within the RCM department and with other departments.

8. Payer & Department Coordination

8.1 Maintain professional communication with insurance companies, TPAs, and other payers.

8.2 Coordinate with Reception regarding eligibility, registration, insurance information, and patient financial responsibility.

8.3 Coordinate with clinical departments regarding approvals, documentation, and insurance requirements.

8.4 Coordinate with Finance regarding collections, reconciliation, and outstanding receivables.

8.5 Participate in meetings with payers or management when required.

9. Reporting & Performance Monitoring

9.1 Prepare daily, weekly, and monthly RCM reports as required by management.

9.2 Monitor key RCM indicators including:

• Claims submission turnaround time.
• Claim rejection and denial rate.
• Resubmission rate and recovery.
• Outstanding accounts receivable.
• Collection rate.
• Authorization turnaround time.
• Payment discrepancies and underpayments.

9.3 Analyze RCM performance trends and provide recommendations for improvement.

9.4 Report significant financial risks, recurring payer issues, and revenue leakage to management.

10. Quality, Compliance & Confidentiality

10.1 Ensure RCM activities comply with organizational policies, applicable DOH requirements, payer requirements, and UAE healthcare regulations.

10.2 Maintain accurate documentation and records for audit and regulatory purposes.

10.3 Participate in internal audits, quality improvement, risk management, and corrective action activities as required.

10.4 Maintain strict confidentiality of patient, financial, employee, insurance, and organizational information.

10.5 Ensure patient information is accessed and shared only for authorized operational purposes

Pay: AED7,000.00 - AED9,000.00 per month

Application Question(s):

• How many years of experience as RCM in Al Ain or Abu Dhabi?

Location:

• Al-Ayn (Required)

Work Location: In person