Finance & Revenue Cycle Management Specialist

Overview

The Finance & Revenue Cycle Management Specialist will oversee financial operations for KAUST Health, including revenue cycle management, insurance claims handling, billing validation, financial reporting, and budgeting. This role collaborates closely with KAUST Health leadership, finance teams, healthcare providers, insurers, and other stakeholders to ensure efficient and accurate financial processes within healthcare services.

Key Responsibilities

• Review and ensure accuracy and compliance of healthcare invoices, quotations, and financial transactions.
• Manage and supervise Revenue Cycle Management and insurance claim procedures.
• Validate insurance claims ensuring timely submission to insurance companies.
• Track and handle claim rejections, denials, resubmissions, and collections, implementing necessary corrective steps.
• Lead the reconciliation of claims, payments, and accounts with healthcare operators and insurance providers.
• Prepare and oversee annual budgets, forecasts, and expenditure controls for KAUST Health.
• Generate monthly financial, variance, revenue, and revenue cycle management performance reports for management review.
• Monitor key financial and RCM KPIs, identifying risks, inconsistencies, and opportunities for optimizing revenue.
• Coordinate among KAUST Finance, Health leadership, healthcare providers, and insurers to resolve financial and claims-related challenges.
• Support audit activities, ensure compliance, maintain financial controls, and help improve revenue cycle efficiency.

Required Qualifications and Experience

• Educational requirement: Bachelor's degree in Finance, Accounting, Business Administration, Healthcare Management, or related fields; Finance or Accounting degrees are preferred.
• Master’s degree and professional certifications such as CPA, CMA, ACCA, or equivalent are advantageous.
• Minimum of six years’ relevant professional experience with at least three years in senior or lead roles such as Senior Specialist or Supervisor.
• Substantial expertise in healthcare finance, medical billing, revenue cycle management, insurance claims processing, and financial operations.
• Demonstrated ability in insurance claim validation, submission, reconciliation, managing rejections, denials, and collections.
• Proven proficiency in financial analysis, budgeting, forecasting, and preparing management reports.
• Hands-on experience monitoring and managing healthcare budgets and expenditures.
• Experience liaising with healthcare operators/providers and insurance companies.
• Skilled in identifying and resolving billing, claim, and payment discrepancies.
• Ability to prepare comprehensive financial and revenue cycle management reports for senior management.