Heathcare Bureau: Billing Analyst

An exciting opportunity exists with a Healthcare IT company in Umhlanga for a Bureau Billing Analyst.

**Outputs and Responsibilites include**:

- Define and execute the billing and coding processes for the Claims Administration department;
- Lead and mentor the Team to ensure precision, accuracy and efficiency when billing Healthcare claims;
- Identify opportunities to optimise Coding and Claiming practices as well as Revenue collection to ensure Revenue Cycle Management goals are met;
- Work with the Line Manager and Supervisor to ensure the Financial health of Medical Practices by driving accurate and efficient Coding and Billing practices in accordance with Industry Standards;
- Guide the Team to interpret and implement Scheme Benefit rules and assess rejected claims to identify and resolve coding errors and discrepancies;
- Conduct research on Medical Aid Plans, Eligibility and coverage to ensure proper billing practices are adhered to;
- Collaborate with Healthcare Providers to ensure they are enrolled in appropriate Medical Aid Payment arrangements;
- Engage with the Technology Teams to help advance the business's digitization goals by contributing to the establishment of an Automated billing engine.
- Test and validate newly built automation as well as integrate newly built automation into existing workflows while minimising disruptions.

**Job Requirements**

**Qualifications & Experience**:

- A minimum of 3 years experience in a similar medical administrative billing role in a business-to-business (B2B) context, within the healthcare sector;
- A minimum of 5 years extensive coding experience in the medical billing industry, showcasing a comprehensive understanding of coding practices and industry standards;
- A proven track record navigating and optimising billing processes within the Healthcare Industry, with a keen eye for detail and compliance with coding and billing standards and regulations;
- Proven collaboration with Technology and Software teams. Clear problem articulation as well as adeptness in testing and integrating software solutions and new features into existing workflows.

**Knowledge, Skills and Technical Competence**
- Extensive experience working at a Master level on PMA’s (Practice Management Applications), demonstrating a versatile and comprehensive understanding of various systems;
- Outstanding expertise in ICD-10 coding and an excellent understanding of SAMA (South African Medical Association) and CMS (Centers for Medicare & Medicaid Services) rules;
- An excellent medical background, showcasing proficiency in medical terminology and a comprehensive understanding of human anatomy;
- Full understanding of the processes, procedures, and systems used in the execution of revenue cycle management, with a focus on ensuring the accuracy and efficiency of Healthcare billing processes;
- Proficient in Ms Excel, Word, Powerpoint or the Google Workspace alternatives;
- Curious about leading-edge technologies (e.g. AI, machine learning, LLMs);
- A keen focus on task efficiency, coupled with a mindset geared towards consistently measuring and reducing task completion times;
- Developing Standard Operating Procedures (SOPs);
- Target setting and monitoring;
- Management reporting.

**Competencies**
- Excellent communication and people skills (verbal and written)
- Enthusiasm to stay updated with industry developments and emerging trends in the Healthcare sector;
- Strategic and forward-thinking mindset to align relationships with the overall business strategy;
- Strong leadership abilities with the capacity to inspire, motivate and empower Teams, both face-to-face and remotely;
- Exceptional interpersonal and relationship-building skills to establish trust and credibility with clients and internal stakeholders;
- Collaborative and team-oriented approach to work effectively with cross-functional teams;
- Can hold own ground during tough negotiations with different types of stakeholders, while remaining respectful, calm and mindful;
- Excellent problem-solving and decision-making abilities in complex and dynamic situations;
- Results-oriented with a focus on achieving targets and delivering on key objectives;
- Effective time management and organisational skills to prioritise tasks and meet deadlines;
- Adaptability and resilience to navigate through challenges and uncertainty;
- Ethical and professional conduct with a commitment to integrity and confidentiality;
- Dependable and diligent, consistently demonstrating trustworthiness and a strong work ethic.
- **If you dont hear from us within 7 days of applying, you have unfortunately not made the short-list...**_

**Salary**: From R30 000,00 per month