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.

Minimum Qualifications and Experience:  

• Bachelor’s Degree with Anatomy and Physiology.  
• Current SANC registration.
• 3-5 years’ experience in a similar role in private healthcare.
• IDC and CPT coding.
• Must be computer literate.

Minimum Job Requirements:  

• Deliver on the hospital’s 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.