Hospital Bill Auditor

Minimum Requirements:Diploma or Degree in Nursing, Physiotherapy, Clinical Associates, Paramedics as Critical Care Assistants or Emergency Care Practitioners or any other qualification that covers Anatomy, Physiology, Pathophysiology and Microbiology as foundational coursesCurrent SANC registration appropriate to relevant medical qualificationKnowledge of the Life Bill Audit Toolkit, clinical codingLife Case Manager Toolkit an advantageKnowledge of hospital patient services and billing processesKnowledge and understanding of CPT/CCSA & ICD codingKnowledge or clear understanding of hospital industry and practicesProficient on MS Office SuiteResponsibilities:Evaluate data accuracy to identify deviations and make recommendations for corrective action and implement and monitor sameAnalyse data trends relating to rejections, short payments and Edit accommodationsDevelop and maintain sound relationships with internal customers to achieve co-operation & compliance with audit processesCompile and maintain a bill audit file containing copies of the edit accommodation reports, late charges and bill audit reports (per file) all signed by PSMSupply proof of completed bill audit reports with additional copies placed in patient filesAudit pre-set number of files according to Life standards, in order to achieve monthly targetVerify the following:The presence of a completed checklist on fileThe presence of copies of patient ID and medical aid on filePatient details on IMEDSThe presence of accurately completed and signed bed letter on fileThe carrier code detail on IMEDS to correspond with Patients medical aid cardThe presence primary and secondary ICD and CPT codingVerify and align proof listing to charge sheetVerify and confirm accuracy of billingThe accuracy of discharge dates corresponding to patient datesVerify and confirm if the correct equipment was charged according to the Patients procedureCompare the prosthesis invoice to charges on IMEDS and verify presence of invoice on fileThe correct billing of theatre gases, modifiers, stock & timeThey correct billing of oxygen usageThe correct billing of ventilator chargesThe statistics on number of elective cases that went to the pre-admission clinicComplete a bill audit template on each file auditedComplete the bill audit toolkit and any updates were requiredSuccessfully complete the LHC coding course and achieve a set pass rateAnalyse audit results and make recommendationsCompile and submit a monthly bill audit reportAnalyse & report trends on rejectionAnalyse & report trends on short payment reportAnalyse & report late chargesAnalyze & report Edit accommodationsEffective monitoring of patient services process complianceAnalyse trends to identify deviationsReport on deviations and influence Stock Controllers & Billing Clerks through presentations and discussion in monthly RSRT meetings & bill audit reports; to drive process of corrective actionMonitor effectiveness of implementation of action plansTO APPLY:Only if you meet the minimum job requirements and experience as mentioned above, you may submit a detailed updated CV.Please Apply Online and complete your registration via our website to enable and protect you as a candidate and to accept the new POPIA terms and conditions.This will then create your permanent profile with which you can apply for all jobs as advertised by AJ PERSONNEL.However, you may remove your profile from AJ PERSONNEL when you are no longer in the job market.Please take note that the applicants who do not adhere to the minimum requirements will not be considered for the respective position.Note our clients may expire jobs at their own discretion.AJ PERSONNEL will only respond to shortlisted candidates.If you have not received a response within two (2) weeks from applying, your application was then unsuccessful for that specific position, however your profile remains on our system for future opportunities.