Company description:The Clinix Health Group helps communities to live longer healthier lives through the provision of quality and affordable healthcare. The group provide integrated world-class healthcare systems both internally and externally to the broader ecosystem to become a trusted local citizen.        

Job Title                            : Patient Services Manager

Location                            : Clinix Health Group – Hospital/s

Reports to                        : Group Patient Services Manager

JOB SUMMARY

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.

REQUIREMENTS

Minimum Qualifications:

• Registered Nurse with a Bachelor`s degree/ Relevant Bachelor's degree.
• Intermediate or Advanced CPT and ICD-10 clinical coding.

Minimum Experience:

• 3-5 years’ experience in a similar role in private healthcare.
• Must demonstrate exceptional communication skills along with excellent customer service skills.
• Vast Experience in Billings and Case Management .
• Working knowledge in Operating Theatre and ICU.
• Hospital Operations
• Clinical coding standards and protocols
• Revenue cycle management (Patient administration)

KEY COMPETENCIES:

• Must be computer literate
• Good management skills
• Conflict management skills
• Knowledge of private health care operations
• Building relationship / Establishing rapport
• Critical judgement
• Continuous improvement

DELIVERABLES

• Ensure efficient management Reception, Admissions, Case Management and Billing Auditing departments.
• 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 minimization capital loss.
• Conduct daily EOC (End of Case) reconciliation to ensure billings are done within the allotted timeframes per funder standards.
• Ensure case managers Maintain up-to-date register of length of stay and update the funders regularly to ensure all services rendered are paid.
• Lead and drive the accurate and business billing process to ensure Patient Services metric targets are achieved.
• Analyse data trends relating to rejections and short payments.
• Inspect work performed in the revenue cycle management team and ensure work is performed according to CHG quality standards
• 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
• Investigate and understand Funder, Doctors, Nurses and Patient needs to enable delivery of a quality service
• Maintain accurate records of patient care and timeously submit to funders to ensure the organisation is appropriately reimbursed for all services rendered
• Adhere to statutory standards, policies and procedures within the business unit to ensure compliance at all times and take remedial action where necessary