RCM Quality Assurance Analyst

About the Role

Al Salama Hospital is seeking a RCM Quality Assurance Analyst to enhance revenue integrity and support evidence-based decisions across the revenue cycle. This full-time role involves transforming operational and financial data into reliable reports, dashboards, and audit findings. The analyst will report to the Director, RCM, and collaborate with various departments to identify gaps and recommend measurable improvements.

Key Responsibilities

• Extract, consolidate, and validate RCM data from hospital systems to produce recurring operational and reconciliation reports.
• Investigate data discrepancies with responsible departments and maintain data dictionaries and version-controlled reporting records.
• Draft and maintain RCM quality assurance procedures, audit checklists, and monitoring tools.
• Conduct sample-based quality checks on billing, claims, approvals, denials, contract billing accuracy, and coding data.
• Document audit findings, evidence, risk levels, and recommended corrective actions, and track their closure.
• Support compliance reviews and accreditation evidence for CHI, MOH, CBAHI, and JCI, and assess NPHIES-related data quality.
• Build and maintain RCM KPI dashboards, including denials and rejections by payer and department, and productivity trends.
• Analyze turnaround times, payer behavior, and variance trends to identify risks and performance gaps.
• Prepare and present monthly management review reports with clear findings and recommendations.
• Identify denial drivers, recurring errors, and potential revenue leakage through root-cause analysis.
• Recommend workflow, control, and automation improvements, and coordinate system-rule testing with ICT.
• Measure results before and after improvement initiatives, and guide stakeholders on using dashboards correctly.

Required Qualifications and Experience

• Bachelor’s degree in Health Informatics, Data Analytics, Statistics, Finance, or Health Information Management.
• At least 3 years of experience in data analysis, quality assurance, or reporting within healthcare revenue cycle management or hospital administration.

Preferred Qualifications

• A Master’s degree in Data Analytics or Healthcare Quality Management.
• A relevant certification such as CPHQ (Certified Professional in Healthcare Quality).
• Experience building RCM dashboards, financial reconciliation reports, and audit frameworks in a hospital setting.

Work Environment

The RCM Quality Assurance Analyst will collaborate closely with the RCM team, Finance, Quality, Internal Audit, and ICT departments to achieve departmental and hospital objectives.