Job Description

• 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/ funders

Minimum Requirements:

• Bachelor’s Degree: Nursing
• Business-Related Degree Theatre or Critical Care Diploma
• 5-7 years’ experience as a Patient Services Manager.
• ICD-10 and CPT coding experience.
• Revenue Cycle Management experience.

Minimum work experience:

• Develop and implement a Group Strategy on short-payment management to improve cashflow
• Implement funder contracts pertaining to the revenue cycle and monitor compliance
• Identify training needs for the revenue cycle department and provide training
• Ensure that new tariffs and billing rules are loaded accordingly on the approved system
• Ensure the monitored addition of new CPT / ICD coding onto the CHG approved system
• Assist in implementing relevant systems and modules at hospital levels
• Monitor the EDI report to ensure all queries have been resolved and all cases are End of Case
• Provide support to PSMs at hospital level to ensure CHG standards and targets are met
• Ensure compliance to Group working procedures and assist hospitals to develop hospital specific services areas
• Ensure PSMs at hospital level provide adequate support to hospital managers to monitor and enforce the use of mobile billing
• Review revenue (RPPD) and debtors’ days by analysing reports received from Group Finance in terms of budget v actual revenue and address improvement opportunities with hospitals.
• In collaboration with relevant stakeholders, review services on SAP to ensure optimization of billings of service
• Set goals and standards for patient services managers across the group and monitor for adherence
• Develop and embed relevant revenue cycle management policies, processes and standards
• Manage relationships with internal and external stakeholders to enable optimisation of the business value chain
• Attend operations meetings with Funder Relations team and hospital-based PSM and provide expertise advice and give feedback as required
• Sponsor company initiatives and projects as it relates to the Group Finance and Group Patient Services
• Comply with cost controls in order to achieve section budget
• Ensure financial documentation is maintained to support accurate record keeping and future requirements as per legislation
• Escalate potential risks that may lead to increased costs or financial losses
• Ensure complete, timeous and accurate reporting with appropriate levels of escalation to enable effective decision making
• Drive adherence to statutory standards, policies and procedures within the business unit to ensure compliance at all times and take remedial action where necessary