Business Analyst - Revenue Cycle Management

Job Description

The Business Analyst serves as the liaison between clinical operations, finance, and IT teams for RCM system implementation at King's College Hospital Dubai and satellite locations. This Dubai-based role requires expertise in UAE healthcare revenue cycle combined with business analysis proficiency to ensure compliance with DHA regulations and NABIDH standards.

Working under the Application Manager, the BA translates clinical and financial workflows into technical specifications while ensuring seamless integration insurance provider.

The role encompasses requirements gathering, process analysis, NABIDH integration design, payer connectivity specifications, testing coordination, and user training across KCH Dubai locations.

• Gather and document requirements from clinical, finance, coding, and operations teams specific to Dubai operations.
• Conduct analysis of current workflows to identify inefficiencies in Dubai insurance processing and DHA compliance gaps. Create BRDs and FRDs aligned with DHA standards.
• Take ownership of RCM projects from requirements through UAT and go-live. Translate Dubai healthcare insurance workflows into functional specifications including Emirates n.
• Analyze market trends and DHA regulatory changes to inform system enhancements.
• Provide actionable intelligence on billing performance by analyzing data from payers, DHA systems, and NABIDH exchanges.

• Monitor specific KPIs: claim acceptance with Dubai insurers, DHA compliance metrics, NABIDH data quality, payer denial patterns.
• Prepare reports and dashboards for DHA regulatory compliance status, NABIDH submission statistics, and Dubai payer performance.

• Document payer requirements: pre-authorization to insurers, payer portal specifications, Emirates , claim Processing, submission, resubmissions and reconciliation requirements.
• Define comprehensive NABIDH integration requirements as mandated by DHA: NABIDH MDS compliance, HL7 v2.5.1 message specifications, real-time patient demographic synchronization, clinical data sharing (encounters, diagnoses, procedures, medications, labs), SDWAN connectivity with DHA infrastructure, patient consent management per DHA privacy regulations, NABIDH audit logging and compliance monitoring. Ensure compliance with Dubai medical coding: ICD-10-AM, CPT, DRG per DHA standards.

• Collaborate with IT teams, , and DHA compliance officers to design solutions meeting KCH requirements.
• Define system configuration for operations insurance plan setup, payer contracts, DHA-approved fee schedules, authorization rules. Create functional specifications for RCM modules:
  Emirates /verification, payer eligibility verification, NABIDH encounter submission, claim generation. Document encounter workflows: hospital admission notifications, discharge processes, NABIDH real-time reporting, IP coding requirements.
• Specify payer portal integrations specific to eligibility checks.

• Develop test cases for workflows.
• Coordinate UAT with users: registration staff, authorization coordinators, coders, billing specialists across Dubai locations.
• Validate NABIDH integration: HL7 message exchange with DHA systems, MDS compliance verification, real-time data synchronization.
• Ensure DHA regulatory compliance: audit trails, privacy controls, reporting capabilities, JCI accreditation standards. Verify Dubai insurance processing:
  Saada claim generation, payer-specific edits, authorization extensions, denial management.

• Stay current with DHA regulatory updates, insurance policy changes, NABIDH technical specification revisions, and Dubai healthcare best practices.
• Support change management for staff including Training materials were beneficial.
• Document specific SOPs: insurance verification, NABIDH submission, authorization processes, DHA compliance protocols.
• Participate in healthcare forums, DHA stakeholder meetings, and payer advisory groups.
• Provide optimization recommendations based on billing performance,…