Billing Quality Specialist

3 weeks ago

المملكة العربية السعودية, Saudi Arabia King Faisal Specialist Hospital and Research Centre Full time

Assumes responsibility for the implementation of the billing quality plan within the Quality Management (QM) Department under the supervision of the designated individual, as assigned.

**Essential Responsibilities and Duties**:

- Provides support for timely, accurate and inclusive charge capture, coding and billing functions and works collaboratively with Financial Services and Health Information Technology Affairs (HITA).
- Develops the billing quality plan's goals and objectives, as well as monitors key performance indicators.
- Oversees all activities related to assigned function under (QM) Department.
- Oversees the annual/ periodic schedule(s) of the billing reviews activities including additional more focused or in-depth audits.
- Oversees clinical responsibilities within related specialty such as (Nursing, Laboratory, Respiratory, Pharmacy, etc.) as assigned.
- Oversees various types of billing reports, such as executive reports and presentations, as well as operational reports.
- Supervises billing reviews activities and prepares required reports and follow-up actions based on the reviewresults.
- Assists clinical departments with charge documentation and capture in the Clinical Information System or Financial System.
- Reviews charge capture review reports to ensure that the correct charges have been deposited into the patient's account.
- Perform clinical responsibilities within related specialty such as (Nursing, Laboratory, Respiratory, Pharmacy, etc.) as assigned.
- Reviews the Quality Analyst's work assignments as required.
- Follows all Hospital’s related Policies and Procedures.
- Participates in self and others' education, training and development, as applicable.
- Performs other related duties as assigned.

**Education**:
Master’s or Bachelor’s Degree in Nursing, or other Healthcare related discipline is required.

**Experience Required**:
Six (6) years of related experience with a Master’s, or eight (8) years with a Bachelor’s Degree is required.

**Other Requirements(Certificates)**:

- Certified Professional Healthcare Quality (CPHQ), Certified Professional Healthcare Risk Management (CPHRM), or any related Healthcare Quality certificate is required.
- Certifications in Lean, Six Sigma and/ or other PI methodologies are preferred.

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