Finance & Revenue Cycle Management Specialist

The KH Finance & Revenue Cycle Management (RCM) Specialist will be responsible for overseeing the financial management, healthcare revenue cycle, insurance claims, billing validation, reconciliation, budgeting, and financial reporting activities for KAUST Health.

The role will work closely with KAUST Health leadership, Finance teams, healthcare operators, insurance companies, and other stakeholders to ensure accurate and timely processing of invoices, quotations, insurance claims, and payments.

The position will play a key role in reducing claim rejections and denials, improving collections, identifying financial discrepancies, maintaining budgetary control, and ensuring transparency and compliance across healthcare financial and revenue cycle activities.

Key Responsibilities

1. Review and validate healthcare invoices, quotations, and financial transactions for accuracy and compliance.
2. Manage and monitor healthcare Revenue Cycle Management (RCM) and insurance claim processes.
3. Validate insurance claims and ensure accurate and timely submission to insurance companies.
4. Monitor claim rejections, denials, resubmissions, and collections and implement corrective actions.
5. Lead claims, payment, and account reconciliations with healthcare operators and insurers.
6. Prepare and monitor annual budgets, forecasts, and expenditure controls for KAUST Health.
7. Prepare monthly financial, variance, revenue, and RCM performance reports for management.
8. Track key financial and RCM KPIs and identify risks, discrepancies, and revenue optimization opportunities.
9. Coordinate with KAUST Finance, Health leadership, healthcare operators, and insurers to resolve financial and claims issues.
10. Support audits, compliance, financial controls, and process improvements to enhance revenue cycle efficiency.

Requirements

Education

• Bachelor’s degree in Finance, Accounting, Business Administration, Healthcare Management, or a related field.
• Bachelor’s degree in Finance or Accounting is preferred.
• Master’s degree in Finance, Accounting, Business Administration, or a related field is preferred.
• Professional certifications such as CPA, CMA, ACCA, or equivalent are an advantage.

Experience

• Minimum 6 years of relevant professional experience.
• At least 3 years of experience in a Lead, Senior Specialist, Supervisor, or equivalent role.
• Proven experience in healthcare finance, healthcare revenue cycle management, medical billing, insurance claims, or healthcare financial operations.
• Strong experience in insurance claim validation, submission, reconciliation, rejection/denial management, and collections.
• Proven experience in financial analysis, budgeting, forecasting, and management reporting.
• Hands-on experience managing and monitoring healthcare budgets and expenditures.
• Experience working with healthcare operators/providers and insurance companies.
• Experience identifying and resolving billing discrepancies, claim discrepancies, rejected claims, and payment variances.
• Experience preparing financial and RCM reports for senior management.