A vacancy exists for a Bill Auditor based at Life Vincent Pallotti Hospital, reporting to Ester Van Der Walt, the Patient Services Manager. The successful candidate will be responsible for conducting retrospective audits of patient documentation, in order to identify and highlight areas of weakness, recommend corrective action and monitor effective implementation thereof, and assist with case management during times of operational necessity in support of Life Healthcare objectives and strategy.

 

Critical Outputs

Effective delivery of quality customer care

 

Evaluate data accuracy to identify deviations and make recommendations for corrective action, implement and monitor same

Analyse data trends relating to rejections and short payments etc.

Develop and maintain sound relationships with internal customers to achieve co-operation and compliance with audit processes

Compile and maintain a bill audit file containing copies of documentation as per LHC protocols

Effective auditing of patient documentation

 

Audit pre-set number of files according to Life standards, in order to achieve monthly target

Complete a bill audit template on each file audited

Complete the bill audit toolkit and any updates where required

Complete, successfully, the LHC coding course and achieve a set pass rate

Analyse results and make recommendations

Compile and submit a monthly bill audit report

Effective auditing of hospital operational processes

 

Verify statistics on number of elective cases that went to PAC, analyse and report trends on rejection and on med-central short payment report, analyse and report late charges etc.

Effective monitoring of patient services process compliance

 

Analyse trends to identify deviations, report on and influence Stock Controllers & Billing Clerks through presentations and discussion in monthly RSRT meetings & bill audit reports

Monitor effectiveness of implementation of action plans

 

Requirements

 

Appropriate medical qualification (i.e. EN, RN or similar)

Current SANC registration appropriate to relevant Medical Qualification an advantage

Knowledge of hospital patient services and billing processes

Knowledge and understanding of CPT & ICD coding

Knowledge of Funder contracts, scheme rules, exclusions and benefits

Understanding of private hospital industry and practices

Computer proficiency

 

Competencies

 

Problem-solving, analysis and judgement

Attention to detail

Resilience

Engaging diversity

Verbal & written communication skills

Influencing

Action orientation

Building relationships

Customer responsiveness

Organisational awareness

Excellence orientation

Ethical behaviour

 

Interested candidates can send their CV