Pricing Analyst

Job Description

Pricing Analyst (UAE National) I AF Health I Healthcare

Key Responsibilities:

• Responsible for the accurate update of agreed prices & discounts in the billing system. update business rules and set the monitoring toll to –control corporate data billing. Contracting and pricing activities 
• To act as a liaison between RCM and IT to update the agreed price list with agreed discount
• Responsible for updating clinics and DSU billing tariff (price updating, plan creation, bill code creation, package creation, cost estimates.
• Oversee and monitor correct billing and auditing of day surgery and outpatient claims.
• Responsible to monitor and prepare clinics/day case monthly revenue report, unbilled report, credit settlement, advance and consumption report and reconcile it for financial accounting.
• Provides support and coordinates with various departments to maintain smooth operational workflow.
• Communicates with internal and external stakeholders for their billing queries and issues and resolve it for accurate processes of billing transactions
•  Coordinates and provides regular training to staff with respect to various Billing process, Approval Protocols & Procedures.
• Provides appropriate guidance to employee by researching, developing, updating billing policy, procedures, method as per guidelines.
• Provide all the needful support as advised by the line manager on the business need.
• Gather relevant details and information to describe and properly escalate issues to Managers and higher officials.
• Proposing new ideas which assure continuous improvement in the billing processes,
• Monitory of surgery and higher value claims accurate billing .
• Reconcile facility Unbilled order report (open bills report).
• Ability to handle conflicts/Problems and come out with proposal plan to resolve the conflict after sufficient analysis.
• Actively involved in software implementation process & also suggest in modification & new improvising change for efficient billing cycle.
• Update special packages as per recommended tariff..
• Reconciliation of hospital packages (day surgery, Health check-up, and Antenatal packages).
• Review hospital revenue report on regular basis and investigate suspicious fraudulent activities and takes active measures
• Setting up the system for the new facility, new inclusion of the services etc..
• Support Team in handling complex cases, resolve customer complaints also communicate and discuss with higher management for any operational issue or improvement in work process

Skills

Minimum Qualifications and Knowledge:

•  B.com/finance Graduate from reputed University or any relevant qualification
• Well versed Knowledge of Microsoft applications
• 1-2 years’ experience in a similar role.
• Knowledge and experience in RCM process, ICD-10 codes