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Group Patient Services Manager
1 month ago
To take responsibility for overseeing the revenue cycle value chain from a Group perspective (i.e., Admissions, Case Management and Billings), 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 Qualifications and Experience**:
- Degree/ Diploma in Nursing.
- Diploma in Theatre/ Critical Care Nursing Science or experience.
- Minimum intermediate training in ICD-10 and CPT Coding.
- Post-graduate diploma / degree in financial management/ administration advantageous.
- 3+ years’ experience as Patient Services manager / Patient Admin manager will be advantageous
- 5+ years’ experience as a Billings Manager or Senior Case Manager in a hospital setting.
- Experience in the medical aid industry or administrator will be advantageous. SAP HIS Knowledge.
**Minimum Job Requirements**:
- Attend operations meetings with funders and provide feed -back to teams.
- Operationalize all agreements with funders
- Ensure that new tariffs and billings rules are loaded accurately on the SAP system.
- Ensure the addition of new CPT/ ICD coding, are loaded/ updated appropriately where applicable.
- Ensure identification and addressing training needs for reception, case management and billings.
- Assist in implementing SAP and MediKredit Modules at hospital level.
- Monitor the EDI report from MediKredit to ensure all queries have been resolved and all cases are EOC (end of case).
- Train and provide ongoing support and “trouble-shooting “for any SAP challenges and escalate any specific issues to the IT Manager for resolution.
- Draw reports from SAP system on discharged files and select sample files for auditing.
- Support the Group Pharmacy Manager in the creation of material sets (together with relevant stakeholders) on SAP to ensure optimization of billings of materials (consumables).
- Review services (together with relevant stakeholders) on SAP to ensure optimization of billings of services (equipment).
- Review revenue (RPPD) and debtors’ days by analyzing reports received from Group Finance in terms of budget v actual revenue - address improvement opportunities with hospitals.
- Identify high Rand value cases weekly and ensure that these are final billed as soon as possible after discharge.
- Support Group Nursing services manager to enforce and monitor the use of Mobile Billing.
