Purpose of the role
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
Minimum Qualifications and Experience:
Bachelors Degree in Nursing with Anatomy and Physiology qualifications
Current registration with SANC
2-3 years experience in similar role in private health care.
Intermediate and Advanced CPD and ICD coding
Computer Literacy
Minimum Duties
Deliver on the hospitals 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
