Revenue Assurance Specialist

Role Overview

The Revenue Assurance role is responsible for ensuring accuracy, completeness, and integrity of hospital revenue through internal audits and process controls. The role focuses on identifying revenue leakages, strengthening billing processes, ensuring compliance with policies, and supporting financial optimization across clinical and non-clinical departments.

Key Responsibilities

• Conduct regular internal audits of billing processes across OPD, IPD, pharmacy, lab, and radiology to identify revenue leakages.
• Review patient bills, charge capture, and service utilization to ensure all services are billed accurately and completely.
• Validate package billing, discounts, approvals, and tariff adherence as per hospital policies.
• Analyze revenue gaps, under-billing, and missed charges, and recommend corrective actions.
• Perform process audits and control checks to strengthen billing accuracy and minimize financial risks.
• Coordinate with operations, billing, and clinical teams to resolve discrepancies and improve processes.
• Monitor compliance with insurance, TPA, and corporate billing guidelines.
• Track and report key revenue metrics, audit findings, and recovery opportunities to management.
• Support implementation of standard operating procedures (SOPs) and continuous improvement initiatives.
• Assist in training teams on billing accuracy, documentation, and compliance requirements.