عرض العمل هذا غير متوفر في بلدك.
Senior Manager - Insurance Business Rules / RCM / Denial Management
SantechtureRiyadh, Riyadh Region, Saudi Arabiaمنذ أكثر من 30 يومًا
الوصف الوظيفيAct as a bridge between internal THYNK team and management to communicate the product vision and development. Partner with clients to incorporate their feedback and updates into the product. Coordinate with teams regularly to support the product's vision. Develop functionalities aligned with market practices to enhance the product. Work effectively under pressure and manage multiple reporting lines. Validate claim remittance reports monthly, review denial trends, and provide feedback to improve the rule engine, reducing denials and maximizing remittance. Analyze bypass reports and end-user feedback to improve rules logic, quality, and validation outcomes. Review clients' historical denial reports to identify trends and develop rules to improve revenue integrity. Communicate effectively with internal and external parties, analyzing market insights and best practices to define rules content. Minimum 10 years of experience in claim adjudication lifecycle with payers / TPAs. Experience with Data Analytics tools like Power BI is preferred. Strong analytical skills and attention to detail. Understanding of insurance adjudication guidelines and protocols, especially in the KSA market. Professional certification in Medical Coding is a plus but not mandatory. Knowledge of local regulations and adjudication protocols in KSA. Excellent communication and presentation skills. Proficiency in Healthcare Information Systems. Medical background (Doctor, Nurse, Pharmacist) is highly desirable. Certifications in Insurance and Project Management are highly valued. Seniority level : Mid-Senior level Employment type : Full-time Job function : Finance and Sales Industries : IT Services and IT Consulting
Senior Manager - Insurance Business Rules / RCM / Denial Management
Role Summary : Business Rules Senior Manager
- Responsible for managing the product image and its development through client interface by connecting Content and Business teams (BDU) simultaneously.
- Ensuring and supporting the development of rules content by providing support to internal teams through review, guidance, and validation of activities.
- Reviewing data analytics and extracting insights based on market payers, regulator protocols, claims denial trends, and user feedback analysis.
- Working closely with stakeholders like payers, regulators, healthcare providers, and revenue cycle departments to ensure adherence to market billing standards and protocols, analyzing coding / billing issues for compliance with policies, and addressing payer denials in the KSA market.
Primary Responsibilities
Job Requirements
Additional Information
This job posting is active and accepting applications.
#J-18808-Ljbffr
إنشاء تنبيه وظيفي لهذا البحث
Manager Management • Riyadh, Riyadh Region, Saudi Arabia
وظائف ذات صلة
Play a key role in streamlining our financial operations as a Revenue Cycle Management (RCM) Specialist, guaranteeing accurate and timely billing, coding and claims submission.This position has a d...أظهر المزيدآخر تحديث: 3 منذ أيام
Tamkeen Technologies is in search of a dedicated.Business Continuity and Risk Management.In this role, you will be responsible for developing and implementing business continuity plans (BCPs) and r...أظهر المزيدآخر تحديث: منذ أكثر من 30 يومًا
- عَرْضٌ مُرَوَّجٌ له
Specialty Hub - Insurance, Broking, Risk Management and Re-Insurance
AonRiyadh, Saudi Arabia Specialty Hub - Insurance, Broking, Risk Management and Re-Insurance.Specialty Hub - Insurance, Broking, Risk Management and Re-Insurance.
Get AI-powered advice on this job and more exclusive featur...أظهر المزيدآخر تحديث: 24 منذ أيام
- عَرْضٌ مُرَوَّجٌ له
Senior Manager - Business Enablement
Shawarmer Food Company LLC.Riyadh, Riyadh Region, Saudi Arabia Senior Manager - Business EnablementCompany : Industry : : Diversified Group Job Location : : Riyadh, Saudi Arabia Career Level : : Senior (Team Leader / Staff Supervisor) Date Posted : : ...أظهر المزيدآخر تحديث: 9 منذ أيام
- عَرْضٌ مُرَوَّجٌ له
Assurance - External Audit Manager / Senior Manager
PricewaterhouseCoopersRiyadh, Saudi Arabia Assurance - External Audit Manager, Senior Manager.As an Audit Manager / Senior Manager, you will oversee an iconic client portfolio and manage the full cycle of audit assignments.Working as part of ...أظهر المزيدآخر تحديث: منذ أكثر من 30 يومًا
- عَرْضٌ مُرَوَّجٌ له
Assurance – External Audit Senior Manager (FS & Non FS) – Riyadh, KSA
PwC Middle EastRiyadh, Saudi Arabia Line of Service Assurance Industry / Sector Not Applicable Specialism Assurance Management Level Manager PwC Global Overview With offices in 152 countries and almost 328,000 people, we are among the ...أظهر المزيدآخر تحديث: 10 منذ أيام
- عَرْضٌ مُرَوَّجٌ له
Senior Manager - Insurance Business Rules / RCM / Denial Management
SantechtureRiyadh, Saudi Arabia Senior Manager - Insurance Business Rules / RCM / Denial Management Role Summary : Business Rules Senior Manager.Responsible for managing the product image and its development through client interface b...أظهر المزيدآخر تحديث: منذ أكثر من 30 يومًا
- عَرْضٌ مُرَوَّجٌ له
Senior risk manager – brokerage
Huxley AssociatesRiyadh, Saudi Arabia Job Description Our client a leading local Investment bank based inSaudi Arabiais seeking a Senior Risk Manager to join their team.
Title : Senior Risk Manager - BrokerageClient : Leading Bank in Sa...أظهر المزيدآخر تحديث: منذ أكثر من 30 يومًا
- عَرْضٌ مُرَوَّجٌ له
Assurance - External Audit Senior Manager
PricewaterhouseCoopersRiyadh, Riyadh Region, Saudi Arabia Assurance - External Audit Senior Manager.As an Audit Senior Manager, you will oversee an iconic client portfolio and manage the full cycle of audit assignments.
You will work within a team of exper...أظهر المزيدآخر تحديث: منذ أكثر من 30 يومًا
- عَرْضٌ مُرَوَّجٌ له
Senior Manager - Business Enablement
Food Basics CoRiyadh, Riyadh Region, Saudi Arabia Senior Manager - Business EnablementCompany : Industry : : Diversified Group Job Location : : Riyadh, Saudi Arabia Career Level : : Senior (Team Leader / Staff Supervisor) Date Posted : : ...أظهر المزيدآخر تحديث: 10 منذ أيام
- عَرْضٌ مُرَوَّجٌ له
Medical Insurance Manager
Dr Sulaiman AlHabib Medical CentersRiyadh, Saudi Arabia Job Purpose / Objective Responsible for development, performance, governance and administration of the insurance provisions for HMG to produce an efficient service.
The position holder will coordina...أظهر المزيدآخر تحديث: 11 منذ أيام
- عَرْضٌ مُرَوَّجٌ له
Senior Manager Healthcare Management Consultant
MedtronicRiyadh, Saudi Arabia At Medtronic you can begin a life-long career of exploration and innovation, while helping champion healthcare access and equity for all.
You’ll lead with purpose, breaking down barriers to innovati...أظهر المزيدآخر تحديث: منذ أكثر من 30 يومًا
Insurance Approval \ Claim (RCM)
National Blood and Cancer CenterRiyadh, Saudi ArabiaQuick Apply
- عَرْضٌ مُرَوَّجٌ له
Senior Manager Assurance and Audit (CDC4) - 20005181
Qiddiya Investment CompanyRiyadh, Riyadh Region, Saudi Arabia Qiddiya is Saudi Arabia’s flagship destination for entertainment, sports, and culture — a cornerstone of Vision 2030 located just outside Riyadh.
Spanning over 360 km², it will feature world-class a...أظهر المزيدآخر تحديث: منذ يوم واحد
- عَرْضٌ مُرَوَّجٌ له
Senior Manager - Business Enablement
AbdalihospitalRiyadh, Riyadh Region, Saudi Arabia Senior Manager - Business EnablementCompany : Industry : : Diversified Group Job Location : : Riyadh, Saudi Arabia Career Level : : Senior (Team Leader / Staff Supervisor) Date Posted : : ...أظهر المزيدآخر تحديث: 10 منذ أيام
- عَرْضٌ مُرَوَّجٌ له
Senior Manager - Business Enablement
Amman BaptistRiyadh, Riyadh Region, Saudi Arabia Senior Manager - Business EnablementCompany : Industry : : Diversified Group Job Location : : Riyadh, Saudi Arabia Career Level : : Senior (Team Leader / Staff Supervisor) Date Posted : : ...أظهر المزيدآخر تحديث: 10 منذ أيام
- عَرْضٌ مُرَوَّجٌ له
Assurance - External Audit Senior Manager (FS) - Riyadh, KSA
PwC Middle EastRiyadh, Saudi Arabia Established in the region for 40 years, PwC has around 12,000 people in 12 countries across the region : Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Oman, the Palestinian territories, Qata...أظهر المزيدآخر تحديث: 6 منذ أيام
Business Continuity and Risk Managment
Tamkeen TechnologiesRiyadh, Riyadh Province, SAQuick Apply
- عَرْضٌ مُرَوَّجٌ له
Senior Manager - Business Continuity Corporate (COR 563)
Qiddiya | القديةRiyadh, Saudi Arabia Senior Manager - Business Continuity Corporate (COR 563).Role Summary : The Senior Manager - Business Continuity Corporate at Qiddiya Investment Company will be responsible for establishing and main...أظهر المزيدآخر تحديث: 17 منذ أيام
- عَرْضٌ مُرَوَّجٌ له
Senior Manager - Business Enablement
Tamatem, Inc.Riyadh, Saudi Arabia Senior Manager - Business EnablementCompany : Industry : : .Diversified Group Job Location : : .Riyadh, Saudi Arabia Career Level : : .
Senior (Team Leader / Staff Supervisor) Date Posted : : .Saudi Arabia...أظهر المزيدآخر تحديث: 9 منذ أيام
- عَرْضٌ مُرَوَّجٌ له
Assurance – External Audit Director (Banking) – Riyadh, KSA
PwC Middle EastRiyadh, Saudi Arabia Line of Service Assurance Industry / Sector Not Applicable Specialism Assurance Management Level Manager Job Description & Summary PwC Global Overview With offices in 152 countries and almost 328,000...أظهر المزيدآخر تحديث: منذ أكثر من 30 يومًا
- عَرْضٌ مُرَوَّجٌ له
Delivery Assurance Director
Mustashar Accelerator - مسرعة مستشارRiyadh, Saudi Arabia You will lead multiple teams of consultants and clients and will have ownership of the end to end delivery of projects, ensuring they meet business objectives.
WHO YOU'LL WORK WITH You will be based...أظهر المزيدآخر تحديث: منذ أكثر من 30 يومًا