Radcare Careers
Outpatient Medical Facility (Imaging, Laboratory, Radiotherapy, Clinics & Home Services)
Riyadh, Saudi Arabia | 🕒 Full-Time 📍
Join our team and drive the growth of our Radcare Center services in Riyadh!
About The Role
The RCM Manager oversees the full revenue cycle from patient registration to final payment collection, ensuring accurate billing, compliance with KSA healthcare payer rules, efficient claims management, and optimized cash flow. The role supports clinical departments including radiology, laboratory, radiotherapy, outpatient clinics, and home healthcare.
Key Responsibilities
A. Revenue Cycle Oversight
- Manage the entire revenue cycle: registration, eligibility, coding, charge capture, billing, claims submission, denial management, collections, and reporting.
- Ensure accurate data flow from clinical departments (radiology, labs, radiotherapy, clinics).
- Lead the implementation and optimization of RCM workflows within HIS/RIS/LIS systems.
B. Insurance & Payer Management
- Maintain strong relations with insurers (cooperative health insurance companies, TPAs).
- Ensure compliance with CCHI, NHIC, and MOH regulatory requirements.
- Monitor payer contract performance, reimbursement trends, and tariff updates.
- Manage pre-authorization workflows for radiology, lab, and radiotherapy services.
C. Coding & Compliance
- Ensure correct application of ICD-10, CPT, HCPCS, and local coding standards.
- Work with clinical teams to ensure proper documentation for high-cost treatments such as radiotherapy.
- Conduct regular audits to ensure coding and billing accuracy.
D. Claims & Denial Management
- Oversee timely submission of electronic and manual claims to payers.
- Analyze reasons for rejections/denials and implement corrective actions.
- Reduce AR days, improve collection rates, and minimize write-offs.
- Ensure reconciliation of submitted claims, remittances, and payments.
E. Patient Billing & Cash Management
- Oversee self-pay billing, discounts, co-pay collections, and financial counseling.
- Ensure transparent pricing for imaging, labs, and home services.
- Manage POS collections at clinics and home-service teams.
F. Reporting & Performance Monitoring
- Develop weekly and monthly RCM KPIs, including:
- AR aging
- Clean claim rate
- Denial rate & root causes
- Days in AR
- Collection rate
- Provide analytical insights to management to improve revenue performance.
- Forecast revenues and support budgeting processes.
G. Team Leadership
- Manage and train staff in registration, billing, coding, approvals, and collections.
- Implement performance review systems and continuous improvement programs.
- Collaborate closely with radiology, lab, oncology, home services, and finance teams.
Performance Indicators (KPIs)
- AR Days ≤ 45 days
- Clean Claim Rate ≥ 95%
- Denial Rate ≤ 5–8%
- Collection Rate ≥ 90%
- Reduction in claim resubmissions and write-offs
- Accuracy of coding and charge capture
Key Competencies
- Strong command of medical billing and payer regulations in KSA.
- Analytical ability to interpret financial and operational data.
- Problem-solving and process optimization mindset.
- Ability to work cross-functionally with clinical and administrative departments.
- High attention to detail, confidentiality, and professionalism.
Qualifications & Experience
- Bachelor’s degree in Healthcare Administration, Finance, Accounting, or related field.
- Preferred: Master’s degree or professional certifications in RCM or Healthcare Finance.
- Minimum 5–7 years RCM experience in a healthcare facility in KSA.
- Strong knowledge of: KSA insurance landscape (CCHI, TPAs, payers) ICD-10, CPT, HCPCS coding Radiology, lab, and oncology billing processes HIS/RIS/LIS and ERP systems
- Experience in outpatient and home-service RCM is an advantage.
- Excellent analytical, communication, and leadership skills.
Ready To Join Us ?
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