JOB SUMMARY
To plan, organize and execute the revenue cycle management at a hospital facility. The incumbent manages a team of specialist that contribute to hospital finances through accurate billing and risk mitigation processes.
REQUIREMENTS
Minimum Qualifications:
- Bachelor’s Degree with Anatomy and Physiology.
- Current SANC registration.
Minimum Experience:
- 3-5 years’ experience in a similar role in private healthcare.
- IDC and CPT coding.
- Must be computer literate.
Added Advantages:
- Advance certification in Intermediate coding.
- Degree in Nursing.
Key Competencies:
- Customer Centricity
- Interactive Communication
- Attention to Detail
- Partnering
- Building relationship/Establishing rapport
- Achievement Orientation
- Critical Judgement
- Continuous improvement
DELIVERABLES
- Deliver on the hospital’s revenue cycle management operating plan.
- Inspect work performed in the revenue cycle management team and ensure work is performed according to CHG quality standards.
- Research, enable and consult on improvements and opportunities to harness technology.
- Review existing processes and suggest innovative ideas to improve and streamline processes to drive efficiencies and minimise redundancy.
- Ensure the development, alignment, mapping and implementation of end-to-end standard operating procedures / processes.
- Ensure efficient management Reception, Admissions, Case Management and Billing Auditing departments.
- Ensure revenue and collections targets are achieved by effectively the department.
- Monitor and ensure WIP (Work-in-Progress) is within the agreed upon periods.
- Ensure overall rejections are within the acceptable threshold.
- Review, audit and sign off on all consignments to ensure accuracy of billing and minimisation capital loss.
- Conduct daily EOC (End of Case) reconciliation to ensure billings are done within the allotted timeframes per funder standards.
- Ensure case managers follow proper coding protocols to reduce rejection rates.
- Ensure case managers maintain an up-to-date register of length of stay and update the funders regularly to ensure all services rendered are paid for.
- Develop and implement admissions process and protocols and ensure the adherence of all admissions staff to maintain standards.
- Ensure that all files requested and utilised are in accordance with CHG standards.
- Review services (together with relevant stakeholders) on SAP to ensure optimisation of billings of services.
- Analyse data trends relating to rejections and short payments.
- Lead and drive the accurate and business billing process to ensure Patient Services metric targets are achieved.