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PIONEER IPM
CQM Coordinator
Job Family Summary:Revenue Operations is characterized by consistency of actions, values, methods, measures, principles, expectations and outcomes. It comprises of capacity management, production planning, timely reporting and timely submission to the insurance companies with coordination with the revenue integrity.Role Summary:The CQM Coordinator role is responsible for keep engaging team members in claims process. Identify network issues and communicate with IT to resolve those. Co-ordination with team members to achieve the organizations’ goalPrimary Responsibilities:· Allocation of claims to the team members. Make sure to allocate claims to each team member· Report back to line managers/onsite managers on any type of claims process issues that may affect the process.· Meet the team on regular basis to discuss on challenges in claims process.· Escalate IT on network issues, track those and keep in shared folder to share with management· Monitor CQM process within given TAT with the provider as well with the end user· Gather relevant information to clearly describe and properly escalate issues to supervisors and managers.· Ensure high quality customer service and respect medical and work ethics at all times while conducting daily tasks.· Ensure that business decisions and processes are documented in a professional way and the communication requirements are being adhered to in a timely and professional manner.· Provide all the needed support as advised by the supervisor based on the business need.· Other related tasks assigned by the line manager
Posted 3 days ago
Supervisor - RCM Operations
Role Summary:The (Senior) Supervisor - Revenue Operations is directly responsible for day-to-day planning, allocation and actual production of claims data entry and coding within shortest possible time, with minimal rework, effort and cost by:(a) Assuming direct responsibility for leading and managing Data Entry function and teams(b) Leading collaboration with CRU and Coding functions. To be successful in this role, the Production Manager must have the ability to forecast claims volume with good precision and proactively adjust capacity to ensure effective utilization of resources.This position reports directly to the Operations Manager Revenue Operations.
Posted 6 months ago
RCM Supervisor
Arabic Speaker with 8 to 10 +years of work experience in the healthcare sector, especially Providers in the UAE NB: Preferable Abu Dhabi ExperienceExperience & good working knowledge of RCM [Payer and Regulator guidelines] in the UAEEducation in any healthcare /life science backgroundLeadership and customer service skillsClaims Analysis and presentation skillsValid UAE driving licenseExcellent communication skills in both English and Arabic [written and spoken]
Posted 7 months ago
Any time
Experience level
On-site/remote
Job type
Premier Class
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