Purpose of the role:To take responsibility for overseeing the revenue cycle value chain from a Group perspective which includes identifying improvement opportunities to optimise billing to maximise revenue.
This includes the reduction of the Groups financial risk by ensuring compliance to Group policies and procedures including contractual arrangements with Medical Schemes/ fundersQualifications & Experience RequiredBachelors Degree: NursingBusiness-Related Degree Theatre or Critical Care Diploma5-7 years experience as a Patient Services ManagerICD-10 and CPT coding experienceRevenue Cycle Management experienceDutiesDevelop and implement a Group Strategy on short-payment management to improve cashflowImplement funder contracts pertaining to the revenue cycle and monitor complianceIdentify training needs for the revenue cycle department and provide trainingEnsure that new tariffs and billing rules are loaded accordingly on the approved systemEnsure the monitored addition of new CPT / ICD coding onto the CHG approved systemAssist in implementing relevant systems and modules at hospital levelsMonitor the EDI report to ensure all queries have been resolved and all cases are End of CaseProvide support to PSMs at hospital level to ensure CHG standards and targets are metEnsure compliance to Group working procedures and assist hospitals to develop hospital specific services areasEnsure PSMs at hospital level provide adequate support to hospital managers to monitor and enforce the use of mobile billingReview revenue (RPPD) and debtors days by analysing reports received from Group Finance in terms of budget v actual revenue and address improvement opportunities with hospitalsIn collaboration with relevant stakeholders, review services on SAP to ensure optimization of billings of serviceSet goals and standards for patient services managers across the group and monitor for adherenceDevelop and embed relevant revenue cycle management policies, processes and standardsManage relationships with internal and external stakeholders to enable optimisation of the business value chainAttend operations meetings with Funder Relations team and hospital-based PSM and provide expertise advice and give feedback as requiredSponsor company initiatives and projects as it relates to the Group Finance and Group Patient ServicesComply with cost controls in order to achieve section budgetEnsure financial documentation is maintained to support accurate record keeping and future requirements as per legislationEscalate potential risks that may lead to increased costs or financial lossesEnsure complete, timeous and accurate reporting with appropriate levels of escalation to enable effective decision makingDrive adherence to statutory standards, policies and procedures within the business unit to ensure compliance at all times and take remedial action where necessary