Job Summary

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. 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 revenue leakage prevention. The position ensures strong internal controls, compliance with payer requirements and continuous process improvement to maximize revenue realization and profitability.

Revenue Assurance and Revenue Integrity

• 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.
• Establish controls to ensure completeness, accuracy and validity of revenue transactions.

Revenue Cycle Management

• 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.
• Monitor turnaround times and revenue cycle KPIs.

Insurance and Corporate Revenue Management

• Review insurance contracts and billing requirements.
• Ensure compliance with payer rules and pre-authorization requirements.
• Monitor insurer deductions, rejections and underpayments.
• Coordinate resolution of disputed claims and outstanding balances.

Revenue Audits and Internal Controls

• Conduct routine billing and revenue assurance audits.
• Perform patient file and system audits to validate charges.
• Investigate anomalies, fraudulent practices and control breaches.
• Recommend corrective actions and monitor implementation.

Data Analytics and Reporting

• Develop dashboards for revenue, collections, denials and leakages.
• Perform trend and variance analysis.
• Prepare monthly reports for executive management.
• Provide actionable recommendations to improve revenue performance.

Compliance and Risk Management

• Ensure adherence to organizational policies and regulatory requirements.
• Support internal and external audits.
• Maintain confidentiality and integrity of financial and patient information.
• Identify key revenue risks and implement mitigation plans.

Stakeholder Management

• Work closely with clinical departments, finance, ICT, health information management and insurers.
• Provide training on documentation, charging and billing requirements.
• Support departmental initiatives aimed at improving revenue capture.

Team Leadership

• Lead, mentor and develop the revenue assurance team.
• Set performance objectives and monitor achievement.
• Conduct coaching, appraisals and succession planning activities.

Continuous Improvement

• Lead automation and digital transformation initiatives in revenue cycle processes.
• Benchmark best practices and recommend enhancements.
• Drive cost efficiency and revenue optimization projects.

Requirements

Bachelor’s Degree in Accounting, Finance, Business Administration, Economics, Health Information Management or related discipline. CPA or ACCA or equivalent professional qualification is strongly preferred.

Revenue Cycle Management certification is an added advantage.

Experience: Minimum of 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.

About Company

C-Care is a leading provider of medical care in Mauritius, Uganda, and Madagascar. From our world-class facilities to our cutting-edge treatments, we strive for excellence and compassion in everything we do at C-Care, from the care we provide to the way we treat our patients and their families.

• 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.
• Establish controls to ensure 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.
• 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.
• Coordinate resolution of disputed claims and outstanding balances.
• Conduct routine billing and revenue assurance audits.
• Perform patient file and system audits to validate charges.
• Investigate anomalies, fraudulent practices and control breaches.
• Recommend corrective actions and monitor implementation.
• Develop dashboards for revenue, collections, denials and leakages.
• Perform trend and variance analysis.
• Prepare monthly reports for executive management.
• Provide actionable recommendations to improve revenue performance.
• Ensure adherence to organizational policies and regulatory requirements.
• Support internal and external audits.
• Maintain confidentiality and integrity of financial and patient information.
• Identify key revenue risks and implement mitigation plans.
• Work closely with clinical departments, finance, ICT, health information management and insurers.
• Provide training on documentation, charging and billing requirements.
• Support departmental initiatives aimed at improving revenue capture.
• Lead, mentor and develop the revenue assurance team.
• Set performance objectives and monitor achievement.
• Conduct coaching, appraisals and succession planning activities.
• Lead automation and digital transformation initiatives in revenue cycle processes.
• Benchmark best practices and recommend enhancements.
• Drive cost efficiency and revenue optimization projects.

• Bachelor’s Degree in Accounting, Finance, Business Administration, Economics, Health Information Management or related discipline.
• CPA or ACCA or equivalent professional qualification is strongly preferred.
• Revenue Cycle Management certification is an added advantage.