Job Title: Patient Services Manager
Location: Clinix Botshelong-Empilweni Private Hospital (Vosloorus).
Job Summary:
To plan, organise and execute the revenue cycle management at a hospital facility. The incumbent manages a team of specialists that contribute to hospital finances through accurate billing and risk mitigation processes.
REQUIREMENTS
Minimum Requirements:
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Bachelors Degree in Nursing with Anatomy and Physiology qualifications.
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Current SANC Registration.
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ICD and CPT Coding.
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Computer Literacy.
Minimum Experience:
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3-5 years’ experience in a similar role in private healthcare.
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ICD 10 and CPT coding.
Added Advantage:
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Advanced certification in CPD and ICD coding.
DELIVERABLES:
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Deliver on the hospital’s revenue cycle management operating plan.
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Inspect work performed in the revenue cycle management team and ensure work is performed according to CHG quality standards.
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Research, enable and consult on improvements and opportunities to harness technology.
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Review existing processes and suggest innovative ideas to improve and streamline processes to drive efficiencies and minimise redundancy.
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Ensure the development, alignment, mapping and implementation of end-to-end standard operating procedures / processes.
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Ensure efficient management Reception, Admissions, Case Management and Billing Auditing departments.
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Ensure revenue and collections targets are achieved by effectively the department.
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Monitor and ensure WIP (Work-in-Progress) is within the agreed upon periods.
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Ensure overall rejections are within the acceptable threshold.
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Review, audit and sign off on all consignments to ensure accuracy of billing and minimisation capital loss.
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Conduct daily EOC (End of Case) reconciliation to ensure billings are done within the allotted timeframes per funder standards.
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Ensure case managers follow proper coding protocols to reduce rejection rates.
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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.
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Develop and implement admissions process and protocols and ensure the adherence of all admissions staff to maintain standards.
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Ensure that all files requested and utilised are in accordance with CHG standards.
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Review services (together with relevant stakeholders) on SAP to ensure optimisation of billings of services
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Analyse data trends relating to rejections and short payments.
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Lead and drive the accurate and business billing process to ensure Patient Services metric targets are achieved.
