A vacancy exists for a Patient Services Specialist, based at Head Office, reporting to the National Clinical Coding Manager. The successful candidate will be responsible for delivering on the patient services strategy, sustaining best operating practices. Supporting and mentoring the Hospital Patient Service teams to reach the Critical Outputs.

Critical Outputs
Ensure effective quality management and customer care by

Manage compliance to Patient Services working procedures and mitigate risks by continuously monitoring controls
Monitoring and improving quality metrics
Managing data integrity
Developing and maintaining relationships with stakeholders
Deliver appropriate information to the business to facilitate the decision-making process and support management.
Ensure effective people management by

Demonstrating visible leadership skills in respect of Life values, operating models and strategies in order to support diversity and transformation
Collaborate with units to achieve clinical coding excellence by application of clinical and coding knowledge
Manage clinical coding training and competency of all staff members responsible to assign clinical coding
Actively leading meetings and ensure participation of all members in order to ensure ISO compliance
Ensuring appropriately qualified and experienced staff members are recruited to fill approved vacancies in accordance with the company’s transformation objectives
Providing direction and inspiration to ensure staff are motivated and productive
Developing and reviewing training plans that are compliant to Life’s WSP requirements in order to enable talent development
Facilitate the management of the performance of staff through the performance improvement process
Facilitate productive working relationships with minimum IR issues
Ensuring all exit interviews are conducted in order to ensure the retention of staff,
Investigate high attrition rates by surveys, analysis of leaver reasons and mitigation of risk for critical skills
Managing people in a manner that respects diversity and ensures a fair work-life balance to ensure employee wellness
Ensure effective and accurate billing by

Driving the accurate and timeous billing process to ensure days sales outstanding (DSO) and working capital management (WCM) targets are achieved
Managing the bill auditing process in order to achieve accurate billing data
Ensuring compliance with the clinical code of conduct to ensure accurate interpretation of a patient event
Ensure effective interpretation & application of contracts and funder rules by

Reducing and managing the risk associated with RSRT’s by making recommendations regarding patient-based data.
Perform audits on the billing and coding with feedback to business on findings and recommendations
Supporting all Patient Services staff members with advice including but not limited to the following areas – admissions, clinical coding, case management, clinical review/bill auditing and funder contracting.
Facilitating effective cash flow management by

Implementing processes from pre-admission to submission of an account to ensure DSO and WCM targets are achieved
Implementing cash management processes to prevent losses
Early identification of financial risk related to clinical coding with subsequent corrective actions and post-implementation measurement.
Ensure effective operational capabilities by

Managing and implementing Patient Services business strategy in order to ensure optimal functioning
Utilising business reports to implement corrective and assistive actions to ensure integrity of data
Continuous business re-engineering focusing on people, processes and technology to ensure integrity of data
Provide support and drive innovation and best practice impacting on quality of data
Governance and risk management by

Preparing and ensuring sound audit compliances to achieve optimum business ethics
Participating in and developing action plans within the risk management teams to appropriate the correct controls
Support tip-off investigations

Requirements

Degree/Diploma as a professional nurse with approximately 5 years post basic, preferably ICU or theatre trained
Strong Quality Management & Controls based focused
Proven leadership and/or people management experience within healthcare.
Comprehensive understanding of billing contracts and funder rules
Strong clinical competency skills and clinical coding, both ICD and CPT
Knowledge of electronic messaging
Knowledge of billing and claims process
Strong interpersonal and self management skills
Computer proficiency (MS office)
Willing to travel

Competencies

Problem-solving, analysis and judgement
Research, planning, organizing implement, Monitor and Reassess processes/procedures
Resilience; Drive & energy
Engaging diversity
Verbal & written communication and presentation
Knowledge of the hospital information system
Knowledge of LHC policies, practices, systems and procedures, protocols.
Excellence orientation
Ethical behavior
Building relationships and Networking
Customer responsiveness
Organisational awareness
Leading by example
Motivating and developing people
Continuous learning and improvement
Knowledge of Human Resource Utilisation
Influencing and Negotiating Skills

Please send your resume/CV