Purpose of the roleTo 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 processesMinimum Qualifications and Experience:Bachelors Degree in Nursing with Anatomy and Physiology qualificationsCurrent registration with SANC2-3 years experience in similar role in private health care.Intermediate and Advanced CPD and ICD codingComputer LiteracyMinimum Duties Deliver on the hospitals revenue cycle management operating planInspect work performed in the revenue cycle management team and ensure work is performed according to CHG quality standardsResearch, enable and consult on improvements and opportunities to harness technologyReview existing processes and suggest innovative ideas to improve and streamline processes to drive efficiencies and minimise redundancyEnsure the development, alignment, mapping and implementation of end-to-end standard operating procedures / processesEnsure efficient management Reception, Admissions, Case Management and Billing Auditing departments Ensure revenue and collections targets are achieved by effectively the departmentMonitor and ensure WIP (Work-in-Progress) is within the agreed upon periodsEnsure overall rejections are within the acceptable thresholdReview, audit and sign off on all consignments to ensure accuracy of billing and minimisation capital lossConduct 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 ratesEnsure case managers maintain an up-to-date register of length of stay and update the funders regularly to ensure all services rendered are paid forDevelop and implement admissions process and protocols and ensure the adherence of all admissions staff to maintain standardsEnsure that all files requested and utilised are in accordance with CHG standardsReview services (together with relevant stakeholders) on SAP to ensure optimisation of billings of servicesAnalyse data trends relating to rejections and short paymentsLead and drive the accurate and business billing process to ensure Patient Services metric targets are achieved