A vacancy exists for a Bill Auditor based at Life Queenstown Private Hospital, reporting to Yandiswa Ntandani, Administration 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, 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

Nursing Qualification, preferably Professional Nurse with at least three years’ experience or Enrolled Nurse with proven case manager and clinical coding experience of at least 3 -5 years.
Current SANC registration is appropriate to relevant Medical Qualification an advantage
Knowledge of the Life Bill Audit Toolkit, clinical Coding and Life Case Manager Toolkit an advantage
Knowledge of hospital patient services and billing processes
Knowledge and understanding of CPT/CCSA & ICD coding
Knowledge of funder contracts, scheme rules, exclusions and benefits
Knowledge or clear understanding of 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

Please send your resume/CV