Advanced Billing and Claims Representative

2 days ago

Dhahran, Saudi Arabia Johns Hopkins Aramco Healthcare Full time

**Job Title**:

- ADVANCED BILLING AND CLAIMS REPRESENTATIVE.

**Job Family**:
**Function**:

- CFO

**Job Code**:

- 30008794

**Reports to Job**:

- Business Unit Lead

**Job Description Summary**:

- The Advanced Billing and Claims Representative is responsible for managing and overseeing the credit and collections process for patient accounts and insurance claims. This role involves but not limited to: handling overdue accounts, resolving billing issues, processing payments, and ensuring compliance with healthcare regulations. The specialist plays a crucial role in optimizing revenue cycle operations, improving cash flow

**Strategic Roles & Responsibilities %**:

- 10

**Strategic Roles & Responsibilities**:

- Works in conjunction with the RCM auditors and Internal Auditors to fulfill any audit and compliance obligationsEnsure compliance with all relevant regulations and industry standards

**Operational Roles & Responsibilities %**:

- 90

**Operational Roles & Responsibilities**:

- Audit claims based on the services charged by the clinical team and process claim supporting documentation
- update regularly the billing systems with the latest claim information corrections and adjustments to ensure data accuracy and consistency
- Generate detailed and summary operational reports on billing and claims activities to monitor performance and identify discrepancies billing trends claim statuses and revenue outcomes
- Analyze current workflows identify bottlenecks or inefficiencies and suggest actionable changes
- support in generating invoices and update billing status in complex orhighvalue cases as needed including Dental and Medical billing
- Engage in responding to inquiries from insurance companies and payers related to individual patientscases and Review incoming and outgoing documents related to invoices and payments

**Minimum Education Required**:

- Bachelor's degree in Business Administration, Finance, or related field. Strong leadership and team management skills, or Master degree in related field with 4 6 years of experience

**Professional Certifications Required**:

- (Certification in revenue cycle management or case management is preferred)

**Years of Experience**:

- Minimum 9 years' experience in credit, collection or related field (ideally in an insurance or healthcare setting)

**Languages**:

- English:Fully Proficient ; Arabic:Basic

**Functional Competencies**:

- Due Diligence
- Audit Reporting
- Data Collection

**Core Competencies**:

- Excellence
- Integrity
- Accountability
- Cybersecurity
- Person-Centered Care

**Acknowledgement**:

- Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

**Addendum Title**:

- No

**Supplemental Work/Experience/Education Information**:

- N/A

**Addendum Description**:

- N/A

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