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