Admin Manager (Hospital Group) – Northern Suburbs, Cape Town 144 views
Job Overview
Requirements:
- Grade 12
- An applicable tertiary qualification will be an advantage
- A minimum 3 – 5 years Management or Supervisory experience
- Knowledge of ICD and CPT Coding
- Knowledge of medical aid rules and fixed fee contracts with Funders
- In depth knowledge and understanding of private hospital billings guidelines
- General accounting knowledge and financial skills
- Ability to work well under pressure and function independently
- Excellent computer skills
Duties & Responsibilities:
- Manage the Admin department and processes with regards to non-releases
- Manage the credit control queries
- Manage Case Manager updates and escalations for medical aids
- Ensure accurate ICD10 and CPT coding
- Analysis of billing errors
- Managing fixed fee contracts with medical aids
- Management of staff
- Daily and monthly reporting to Hospital Manager and Head Office regarding Admin stats
- Month end finalisation of files
- Private patients quotations, financial risk management and daily banking
- Auditing of hospital folder greater than R10K
- Auditing coding on claims and checking if co-morbidities have been captured
- Auditing of clinical data submitted to the medical funder / aid / institute
- Ensuring that the high cost medication process has been followed
- Responsible for the security and accuracy of the patient records
- Liaise with the relevant stakeholders regarding claims, billings, etc. and ensure that all claims / queries have been actioned by the relevant staff members within the department
- Oversee and streamline the billing processes
- Plan and implement quality assurance for all billing and case management processes
- Conduct routine staff meetings regarding billing planning and implementations
- Assist in standardising the methods in which work will be accomplished
