Revenue Cycle Manager

**ABOUT**

Intercare is a dynamic healthcare company focusing on offering value-based healthcare to patients. As ambassadors of the Intercare brand, everything we do is guided by our purpose to make people feel better. Our shared values of People-centred, Integrity, Inclusivity, Excellence and Innovation define what we believe and who we are.

Intercare Corporate Services, situated in Menlyn, Pretoria, seeks to recruit a Revenue Cycle Manager. The purpose of the position is to lead, direct and control staff, processes, and procedures in line with company policies and procedures to ensure effective performance of the Revenue Cycle process within the Intercare Group
**DUTIES & RESPONSIBILITIES**
- ** Revenue Cycle Oversight**:
- Manage the full revenue cycle, including patient registration, charge capture, claims submission, payment posting, and collections.
- Ensure accurate and timely billing to medical aid schemes, patients, and third-party payers.
- ** Claims Management**:
- Oversee submission and follow-up of claims to medical aid schemes (e.g., Discovery, GEMS) and government bodies, minimising rejections and resubmitting rejected claims efficiently.
- Monitor and improve claim approval rates and revenue recovery timelines.
- ** Financial Performance**:
- Optimise cash flow by reducing days in accounts receivable and addressing revenue leakage (e.g., unbilled services, uncollected co-payments).
- Prepare and analyse revenue cycle reports, providing insights to senior management on KPIs such as debtor days, collection rates, and bad debt ratios.
- ** Compliance and Coding**:
- Ensure adherence to South African healthcare regulations (e.g., Council for Medical Schemes guidelines, National Health Act) and readiness for National Health Insurance (NHI) developments.
- Supervise accurate use of billing codes (e.g., ICD-10, procedural tariffs) to support compliant and successful claims.
- ** Team Leadership**:
- Lead, train, and motivate the RCM team, fostering a culture of accuracy, efficiency, and patient sensitivity.
- Develop staff skills in medical billing, coding, and customer service.
- ** Process Improvement**:
- Implement and maintain RCM systems (GoodX, SharePoint, PowerBI) to streamline workflows and enhance automation.
- Identify and address inefficiencies in the revenue cycle, collaborating with clinical and administrative teams to improve payment allocation, payment methods, patient communication, and registration processes.
- ** Stakeholder Collaboration**:
- Work closely with patient administration, clinical staff, and IT teams to ensure seamless revenue cycle operations.
- Liaise with medical aid schemes and external partners to resolve payment disputes and improve reimbursement processes.
- ** Patient Experience**:
- Oversee patient billing communications, ensuring clarity and sensitivity, particularly for underserved or uninsured patients.
- Address patient queries related to billing or medical aid shortfalls in a professional and empathetic manner.

**REQUIREMENTS**
- ** Education**:
- Bachelor’s degree in Finance, Accounting, Healthcare Management, or a related field.
- Additional certification in medical billing/coding (e.g., ICD-10 certification) or revenue cycle management is highly advantageous.
- ** Experience**:
- Minimum of 5 years’ experience in revenue cycle management, billing, or financial management within a healthcare setting.
- At least 2 years in a supervisory or managerial role.
- Proven track record of managing claims with South African medical aid schemes and improving revenue outcomes.
- ** Technical Skills**:
- Proficiency in RCM or financial software (e.g., GoodX, Sage) and Microsoft Office (especially Excel).
- Strong understanding of South African healthcare billing codes (ICD-10) and medical aid processes.
- ** Knowledge**:
- In-depth knowledge of South African healthcare regulations (e.g., CMS, NHI framework) and financial reporting standards (e.g., IFRS).
- Familiarity with socio-economic challenges affecting patient payments in South Africa.

**If your personal purpose is aligned to our purpose and your values fit in with our value system, please apply. We encourage Diversity of Thought, and we welcome people to build and add to our culture.**

**CLOSING DATE: 14 March 2025