Senior Executive, Billing Audit

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Sunway Medical Centre Bandar Sunway is Hiring!

Job Purpose:

• Responsible for ensuring the accuracy, integrity, and compliance of the hospital's revenue cycle.

• Involves in conducting in-depth audits of billing practices, collaborating with cross-functional teams to optimize revenue management, and implementing strategies to improve billing efficiency and reduce revenue leakage.

Job Scope:

1. Optimize the resolution of denied claims, focusing on insurance coverage issues, sensitive patient billing, and billing adjustments.
2. Investigate denied claims to identify root causes, such as insurance coverage issues, coding errors, or missing documentation.
3. Ensure adherence to healthcare financial regulations and reimbursement processes by executing effective billing structures.
4. Identify opportunities to automate billing processes, streamline workflows, and reduce manual intervention to enhance efficiency and accuracy.
5. Provide data-driven insights to enhance revenue performance and minimize losses. Present findings to management with clear, data-driven justifications for proposed changes.
6. Stay updated on healthcare regulations and reimbursement guidelines to ensure compliance.
7. Implement strategies to reduce denied claims and improve claim acceptance rates.
8. Conduct regular audits of billing practices to identify and correct errors, such as coding inaccuracies, missing charges, or incorrect billing codes.
9. Monitor and analyze revenue cycle performance metrics to identify trends and potential areas for improvement.
10. Work closely with the Billing Office, IT, and clinical teams to resolve billing system issues, data discrepancies, and coding challenges.
11. Analyze revenue streams, billing performance metrics, and generate reports to identify trends and potential revenue opportunities.
12. Assist in ad-hoc tasks/projects assigned.

Job Requirements:

1. Bachelor's Degree in Healthcare Administration, Finance, Business, Accounting or equivalent. Preferably with certification of ICAEW/ACCA/CPA/MIA/CIMA or equivalent.
2. Minimum 3-5 years of relevant working experience in billing audit, revenue cycle management, or healthcare finance, preferably in a hospital or healthcare setting.
3. Skills: Strong understanding of healthcare insurance and reimbursement regulations, strong knowledge of insurance claim processing and reimbursement methodologies, analytical, problem-solving, interpersonal, and communication skills.

Hiring Process:

1. The average processing time is around 2 to 4 weeks.
2. Subsequently, our recruitment team will reach out to shortlisted candidates for interview arrangements.

Your application will include the following questions:

• What's your expected monthly basic salary?
• How many years' experience do you have as a Billing Executive?
• How much notice are you required to give your current employer?
• Which of the following languages are you fluent in?
• Do you have experience lodging & processing insurance claims?
• How many years of auditing experience do you have?