Group Patients Services Manager (Health Group) – Sandton, Gauteng 54 views

Requirements:

• Bachelor’s Degree: Nursing
• Business-Related Degree Theatre or Critical Care Diploma
• 5-7 years’ experience as a Patient Services Manager
• ICD-10 and CPT coding experience
• Revenue Cycle Management experience

The main purpose of this position:

To take responsibility for overseeing the revenue cycle value chain from a Group perspective 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

Duties & Responsibilities:

• Develop and implement a Group Strategy on short-payment management to improve cashflow
• Implement funder contracts pertaining to the revenue cycle and monitor compliance
• Identify training needs for the revenue cycle department and provide training
• Ensure that new tariffs and billing rules are loaded accordingly on the approved system
• Ensure the monitored addition of new CPT / ICD coding onto the clients approved system
• Assist in implementing relevant systems and modules at hospital levels
• Monitor the EDI report to ensure all queries have been resolved and all cases are End of Case
• Provide support to PSMs at hospital level to ensure clients standards and targets are met
• Ensure compliance to Group working procedures and assist hospitals to develop hospital specific services areas
• Ensure PSMs at hospital level provide adequate support to hospital managers to monitor and enforce the use of mobile billing
• Review revenue (RPPD) and debtors’ days by analysing reports received from Group Finance in terms of budget v actual revenue and address improvement opportunities with hospitals
• In collaboration with relevant stakeholders, review services on SAP to ensure optimisation of billings of service
• Set goals and standards for patient services managers across the group and monitor for adherence
• Develop and embed relevant revenue cycle management policies, processes and standards
• Manage relationships with internal and external stakeholders to enable optimisation of the business value chain
• Attend operations meetings with Funder Relations team and hospital-based PSM and provide expertise advice and give feedback as required
• Contribute to a culture of internal and external customer service excellence, which builds positive relationships and provides opportunities for feedback and exceptional service
• Implement processes which build customer service delivery excellence and encourages others to provide exceptional service
• Provide awareness and education on matters related to Occupational Health, e.g., legislation, health hazards / risk control, safety and health
• Coordinate monitor and supervise the performance of direct reports
• Monitor costs or expenses within approved budget to achieve cost efficiencies and reduce waste
• Compile and report on operational information to feed into management decisions and support the Clinic’s goals