Job Purpose

• 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.

Minimum Qualifications

• Bachelor’s Degree in Nursing or equivalent qualification
• Registration in SANC
• Business Degree or Theatre/Critical Care Diploma will be advantageous

Minimum Experience

• Must have 5 – 7  years’ experience in a similar role
• Knowledge of ICD-10 and CPT coding
• Knowledge in Revenue Cycle management

Key Competencies

• Effective Report Writing and Communication
• Critical problem-solving ability
• Advanced computer literacy
• Strategic Stakeholder Management
• Policy and SOP development

Deliverables

• Develop and implement a Group Strategy on short-payment management to improve cashflow
• Provide support to the Funder relations team as necessary
• Ensure that new tariffs and billing rules are loaded accordingly on the approved system
• Provide support to PSMs at hospital level to ensure CHG standards and targets are met
• Ensure compliance to Group working procedures and assist hospitals to develop hospital specific services areas
• Review revenue (RPPD) and debtors’ days by analyzing 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 optimization of billings of services
• Implement effective controls to ensure accurate billing by:
• Driving the accurate and business billing process to ensure Patient Services metric targets are achieved
• Ensure accurate application and interpretation of specialized wards criteria.
• 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
• Leverage technology to automate and integrate the workplace; ensure system integrity
• Analyse data, and interpret the trends to inform sound decision-making and ensure contingency plans are in place
• Identify innovative ways to improve business practices, processes and synergies to save costs, increase efficiencies and improve service delivery
• Manage stakeholder relationships and quality of service delivery to ensure successful overall business results
• Sponsor company initiatives and projects as it relates to the Group Finance and Group Patient Services
• Demonstrate visible leadership in respect of company values, operating model and strategy
• Ensure good governance including the effective use of management systems to monitor compliance to business direction and policies
• Drive adherence to statutory standards, policies and procedures within the business unit to ensure compliance at all times and take remedial action where necessary