Reconciliation Manager - Healthcare RCM (Insurance Claims)

Job Description

Job Family Summary: The Reconciliation Manager will oversee and lead the insurance reconciliation process for a large Qatar-based public healthcare client. The role involves managing a team responsible for reconciling outpatient and inpatient claim payments, identifying payment variances, and driving corrective actions across the claims lifecycle. The candidate will act as a subject matter expert in Qatar healthcare payer regulations and will work closely with internal teams and external stakeholders to ensure high-quality reconciliation and financial reporting. Role Summary: The Reconciliation Manager will be responsible for leading the end-to-end insurance reconciliation process for a major public healthcare client in Qatar. This role requires in-depth expertise in analyzing payment variances, resolving underpayments, and ensuring accurate alignment between claims submitted and payments received. The ideal candidate will bring strong knowledge of Qatar healthcare payer processes, regulatory requirements (NHIC/QCHP), and experience in managing a reconciliation team within a provider-side RCM environment. This is a strategic role that involves working cross-functionally with coding, submission, and resubmission teams to improve overall revenue integrity and ensure timely closure of receivables. The position is based at our Chennai (Perungalathur) office, supporting the Qatar operations remotely. Primary Responsibilities: Lead the reconciliation and collections team for Qatar outpatient and inpatient medical claims. Ensure accurate, timely reconciliation of claims against remittances from payers, with a focus on reducing payment gaps. Oversee tracking of underpayments, denials, and delayed reimbursements; drive root cause analysis and process improvement. Coordinate with claims submission, resubmission, and coding teams to support end-to-end RCM effectiveness. Prepare and review reconciliation dashboards and payment status reports for internal and client reviews. Stay updated on Qatar RCM regulations, NHIC/QCHP guidelines, and payer-specific payment rules. Ensure high standards in documentation, audit readiness, and internal controls for all reconciliation activity. Maintain clean claim rates and optimize first-pass resolution. Identify operational gaps and proactively recommend improvements to minimize revenue leakage. Collaborate with client representatives and support any external audits or business reviews. Manage the performance and development of a reconciliation team working in back-office operations. Job Requirements: Bachelors or Master's degree in healthcare, or related field Certification in Medical Coding (CPC, CCS, or equivalent) is required Experience working in provider-end RCM for GCC clients especially Qatar is preferred 10+ years of experience in Healthcare Revenue Cycle Management, including reconciliation, collections, or AR operations Prior experience with Qatar or UAE (Northern Emirates) providers or TPAs is highly preferred Strong knowledge of insurance payment processes, denial types, eClaim standards, and coding (ICD-10, CPT) Proven ability to work with large datasets, ERP systems, and financial reporting tools Excellent command of MS Excel for reconciliation and dashboard preparation Knowledge of Qatars eClaim framework and regulatory guidelines (NHIC, QCHP) Strong people management and team leadership capabilities Attention to detail, analytical thinking, and ability to work independently Excellent verbal and written communication skills