A vacancy exists for a Bill Auditor based at Life Empangeni Private Hospital reporting to the Patient Services Manager. The successful candidate will be responsible for managing the financial and clinical risks of the business unit by conducting retrospective audits of patient documentation, in order to identify and highlight areas of weakness, recommend corrective action and monitor effective implementation thereof, in support of the company objectives and strategy.
FunctionPatient services
FacilityLife Empangeni Private Hospital PositionBill Auditor
Critical OutputsEffective delivery of quality customer careEvaluate data accuracy to identify deviations and make recommendations for corrective action and implement and monitor sameAnalyse data trends relating to rejections, short payments and Edit accommodationsDevelop and maintain sound relationships with internal customers to achieve co-operation & compliance with audit processesCompile and maintain a Bill Audit file containing copies of the Edit accommodation reports, late charges and bill audit reports (per file) – all signed by PSMSupply proof of completed bill audit reports with additional copies placed in patient filesEffective auditing of patient documentationAudit pre-set number of files according to Life standards, in order to achieve monthly targetVerify the presence of a completed checklist on fileVerify presence of a copies of patient ID and medical aid on fileVerify patient details on IMEDSVerify presence of accurately completed and signed bed letter on fileVerify carrier code detail on IMEDS to correspond with patient medical aid cardVerify the presence primary and secondary ICD and CPT codingVerify and align proof listing to charge sheetVerify and confirm accuracy of billingVerify accuracy of discharge dates corresponding to patient datesVerify and confirm if the correct equipment was charged according to the patient's procedureCompare the prosthesis invoice to charges on IMEDS and verify presence of invoice on fileVerify correct billing of theatre gases, modifiers, stock & timeVerify correct billing of oxygen usageVerify correct billing of ventilator chargesComplete a bill audit template on each file auditedComplete the bill audit toolkit and any updates where requiredSuccessfully complete the LHC coding course and achieve a set pass rateAnalyse audit results and make recommendationsCompile and submit a monthly Bill Audit reportEffective auditing of hospital operational processesVerify statistics on number of elective cases that went to the pre-admission clinicAnalyze & report trends on rejectionAnalyze & report trends on short payment reportAnalyse & report late chargesAnalyze & report Edit accommodationsEffective monitoring of patient services process complianceAnalyse trends to identify deviationsReport on deviations and influence Stock Controllers & Billing Clerks through presentations and discussion in monthly RSRT meetings & bill audit reports; to drive process of corrective actionMonitor effectiveness of implementation of action plansRequirementsDiploma or degree in Nursing, Physiotherapy, Clinical Associates, Paramedics as Critical Care Assistants or Emergency Care Practitioners or any other qualification that covers Anatomy, Physiology, Pathophysiology and Microbiology as foundational courses.Current SANC registration appropriate to relevant Medical QualificationKnowledge of hospital patient services and billing processesKnowledge and understanding of CPT/CCSA & ICD codingKnowledge of funder contracts, scheme rules, exclusions and benefitsKnowledge or clear understanding of hospital industry and practicesComputer proficiencyCompetenciesAttention to detailProblem-solving, analysis and judgementVerbal & written communication (including presentations)Influencing skillsPersonal integrityPlanning & organisingAbility to build relationshipsDrive and energyProcess orientationIndependenceConflict managementSelf-managementEmail: ****** Closing date: Thursday, October 17, 2024
Internal applicants - Before making an application, you are requested to discuss your application with your line manager. External candidates will also be considered.
Life Healthcare is an Equal Opportunity Employer.
Thank you for your interest in this opportunity. Kindly note that only shortlisted candidates will be contacted. Applicants who have not been contacted within two weeks of the closing date of this advert should consider their application as unsuccessful.
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