Revenue Assurance Manager

Job Details

The Revenue Assurance Manager is responsible for protecting, optimizing and assuring the organization's revenue by ensuring that all services rendered are accurately captured, billed, claimed, collected and reported across C-Care Uganda's hospital service lines. The role provides oversight across the entire revenue cycle including patient registration, charge capture, coding, billing, insurance claims, collections, reconciliations, contract compliance, revenue analytics and leakage prevention, ensuring strong internal controls and compliance with payer requirements to maximize revenue realization and profitability. Based in Uganda, full-time.

Key Duties and Responsibilities

• Develop and implement a comprehensive revenue assurance framework across all hospital service lines.
• Identify, quantify and mitigate revenue leakages through routine reviews and audits; ensure all clinical and non-clinical services are appropriately charged and billed.
• Review pricing structures, tariffs and charge master integrity and establish controls for completeness, accuracy and validity of revenue transactions.
• Monitor the entire revenue cycle from registration to final collection; oversee charge capture, billing accuracy, claims submission and collections.
• Review aged receivables and drive recovery actions; reduce claim rejection and denial rates through root cause analysis and monitor turnaround times and revenue cycle KPIs.
• Review insurance contracts and billing requirements; ensure compliance with payer rules and pre-authorization requirements.
• Monitor insurer deductions, rejections and underpayments and coordinate resolution of disputed claims and outstanding balances.
• Conduct routine billing and revenue assurance audits; perform patient file and system audits to validate charges and investigate anomalies, fraud and control breaches.
• Develop dashboards for revenue, collections, denials and leakages; perform trend and variance analysis and prepare monthly reports for executive management.
• Ensure adherence to organizational policies and regulatory requirements, support internal and external audits and implement revenue risk mitigation plans.
• Work closely with clinical departments, finance, ICT, health information management and insurers; provide training on documentation, charging and billing requirements.
• Lead, mentor and develop the revenue assurance team, set performance objectives and conduct coaching and appraisals.
• Lead automation and digital transformation initiatives in revenue cycle processes and drive cost efficiency and revenue optimization projects.

Qualifications, Skills and Requirements

• Bachelor's Degree in Accounting, Finance, Business Administration, Economics, Health Information Management or related discipline; CPA or ACCA or equivalent professional qualification strongly preferred.
• Revenue Cycle Management certification is an added advantage.
• Minimum 7 years' experience in revenue assurance, healthcare finance, internal audit, revenue cycle management or financial controls, with at least 3 years in a management position.
• Experience in hospital and insurance billing environments is highly desirable.
• Strong knowledge of revenue cycle KPIs, claims management, reconciliations and internal controls.
• Strong analytical, data analytics and reporting skills with ability to develop dashboards and variance analysis.
• Excellent leadership, stakeholder management and training skills.