Key Responsibilities

• Compiling, quality checking and processing of daily billing.
• Find resolutions to billing queries pro-actively
• Ensure invoices are done as close as possible to real time processing, and with the applicable supporting documentation.
• Ensuring billing ties in with accurate stock control.
• Prepare and submit billing reports and perform revenue assurance checks to avoid revenue leakage
• Liaise with all department to ensure accurate and complete billing
• Perform month end processing Financial Administration
• Check if patient has any outstanding previous accounts.
• Assist private patients by preparing the Pre-payment estimate according to hospital guideline using the approved documentation. All estimates to be signed off by Hospital Manager or her designate.
• Identify financial risks pro-actively and communicate these to the Credit Controller.
• Collect payments according to protocols and prepare financial registers daily, accountable for receipting functions as per policy.
• Weekly banking on prescribed documentation according to protocol.
• Maintain a well-run, professional and patient focussed admission environment.
• Manage the accuracy of the admission process and the prevention of potential risk factors.
• Synergy and teamwork–working closely with credit controllers, nursing team, stock controllers and doctors.
• Assist patients to accurately complete appropriate forms and documents for the required information.
• Capture and records patient medical and personal information on the Hospital system in a professional, friendly and timeous manner, focusing on patient and visitor’s needs
• Manage the risk for the hospital by adhering to all related protocols.
• Handling money and receipting according to protocol
• Collection of co-payments, private fees when applicable as well as related documentation.
• Performing general administration duties involved in the pre-admission of patients.
• Billing and releasing of accounts daily within 24 hours.
• Ensuring submission of correct accounts to funders via platforms provided
• Manage and correct all rejected claims daily
• Drive pre-admissions, admissions and confirmations to achieve quality admissions that minimise risk and maximise revenue collections.
• Assist the Credit Controller in ensuring that the medical aid tariff and option changes are implemented through Messages, alerts, to minimise confusion and uncertainties during the change-over period at year end.
• Assist in resolving patient complaints according to Best Practices and monitor patient satisfaction in an effort to drive action plans for improvement
• Communicate effectively with key role players in order to enhance quality management.
• Identify and rectify non-compliance with business policies and procedures.
• Share information of patients and procedures with theatre and wards for theatre and bed planning with accurate information about gender, age, exact description of diagnosis.
• Patients are requested to arrange authorisations–the hospitals assist when requested to do so.
• Update procedures and coding with funders, as and when required.
• Capturing of notes on the system with regards to any of the above is crucial as all parties involved needs to know what was done/approved/arranged
• Provide efficient and professional telephone services
• Assist patients in accurately completing appropriate forms, and document all information in accordance to internal policies and procedures.
• Direct all patients to the appropriate location, services and appropriate nursing or medical professional.
• Ensure patient confidentiality at all times in line with protocol NHA & Poppi Act
• Ensure that the reception area is always neat and tidy.
• To refer all emergency cases to the nurse’s station according to protocol.
• Assist patients with basic account queries and escalate as necessary.
• Collect all co-payments and private account balances according to health policies and procedures.

Requirements

• Grade 12 or equivalent NQF level 4 qualification.
• A National Diploma or Relevant NQF 6 qualification in Administration will be advantageous.
• A minimum of 2-4 years Hospital Healthcare industry experience.
• A minimum of 2-4 years’ experience in the admissions processes in a private hospital environment.
• Billing background is essential.
• Previous experience in pre-admission, admission; confirmation department essential
• Basic working knowledge of ICD and CPT coding essential
• Knowledge of Medical Aid rules, limits and processes essential.
• Proven track record and dedication to quality and superior customer service.
• Understanding the Trimed system and Trimed management reports.
• Sound knowledge of NHN & ADV Billing and Tariff guidelines.
• Knowledge of Alternative Re-imbursement tariffs essential.
• Strong systems knowledge and proficiency in business processes, compliance and governance.
• Relevant computer proficiency (Microsoft Office).
• Good command of English, written and oral.
• Additional language skills would be advantageous
• Good verbal, written and interpersonal communication skills in English.
• Ability to work well under pressure and to maintain effectiveness during changing conditions
• Ability to work effectively and co-operatively with others by establishing and maintaining good working relationships co-workers, stakeholders, clients of the company.
• Excellent planning, organising and control / follow-up skills are essential
• Must be customer care oriented
• Must be able to use initiative to overcome day to day operational roadblocks e.g. systems down.
• Attention to detail and accuracy
• High level of professionalism.
• High level of Logical thinking.
• Ability to meet deadlines.
• Deadline driven.
• Resilience
• Engaging diversity
• Influencing
• Drive & energy
• Excellence orientation.
• Ethical behaviour and honesty.
• In the event of any physical or psychological limitation that may impair the employee’s ability to perform the required job function, the employee must consult the employer for reasonable accommodation.
• Professional flexibility in working hours while supporting daily business hours.
• Will interact with internal and external stakeholders through several different means.