Job Description

We are seeking an experienced Denial Management Manager to lead our Denial Management Unit (DMU) and drive denial prevention, appeals, and revenue recovery initiatives.

Key Responsibilities:

• Lead and oversee the Denial Management Unit across all denial categories.
• Develop and implement denial prevention, appeal, and recovery strategies.
• Monitor denial trends, root causes, and recovery performance across payers and facilities.
• Ensure timely submission and follow-up of appeals in line with payer and regulatory requirements.
• Collaborate with Medical, Coding, Billing, Claims, and Medical Coordination teams to reduce avoidable denials.
• Share in payer escalation discussions and support contractual and operational dispute resolution.
• Develop denial dashboards, KPIs, and executive reports to drive performance improvement.
• Ensure compliance with Saudi healthcare insurance regulations, NPHIES requirements, and payer policies.
• Lead and develop denial management teams to maximize revenue recovery and operational efficiency.

Qualifications

• 5+ years of experience in Healthcare Revenue Cycle Management and Denial Management.
• Previous experience in Saudi healthcare insurance, denial management, appeals, and revenue recovery is mandatory.
• Strong knowledge of NPHIES, Saudi healthcare insurance regulations, payer policies, and reimbursement methodologies.
• Proven experience in denial analysis, root cause analysis, appeals management, and revenue optimization.
• Experience working with major KSA payers is highly preferred.
• Physician (MBBS/MD) background is preferred.
• Strong leadership, analytical, communication, and stakeholder management skills.