Billings Auditor

Description:

To oversee the hospital’s billings process and ensure products and services received by patients aligns with the Rand Value of the final bill. The incumbent performs detailed and accurate audits of patient files, comparing the products and services received with the itemised bill in the context of the Company’s billing requirements and contractual arrangements with Medical Schemes.

This is a short-term contract position, to begin in May 2025.

Minimum Requirements:

• Diploma in Nursing
• 5 years’ experience overall work experience in Billings environment
• Proficient in Billings Processes
• Proficient in Revenue Cycle Management

Minimum work experience:

• Access SAP reports daily, such as:
  

• Review and analyse reports as a management tool, in order to identify negative trends and implement corrective action.
• Conduct sample audits on patient files to assess accuracy and general quality of the work completed by the billings team; identify trends and deviations and implement corrective action.
• Verify charges completed by Departments and accurately check the final bill on the system.
• Ensure the accurate maintenance of supplier invoices.
• Engage proactively with Reception/Admissions, Case Management, Nursing and Pharmacy staff, where applicable, to ensure the least delay possible in ensuring that invoices are final billed.
• Ensure timeous resolution of queries and complaints and take ownership of issues.
• Collaborate and build relationships with the various Departments in order to process the final bill with as little delay as possible.
• Optimise the billing of products and services provided by the hospital and in line with Company requirements and contractual arrangement with Medical Schemes.
• Comply with cost controls in order to achieve section budget.
• Analyse information and reports to identify trends, discrepancies and inconsistencies for decision-making purposes.
• Escalate trends and deviations to relevant Departments and follow up to ensure corrective action has been implemented

Requirements:

To oversee the hospital’s billings process and ensure products and services received by patients aligns with the Rand Value of the final bill. The incumbent performs detailed and accurate audits of patient files, comparing the products and services received with the itemised bill in the context of the Company’s billing requirements and contractual arrangements with Medical Schemes.

This is a short-term contract position, to begin in May 2025.

Minimum Requirements:

• Diploma in Nursing
• 5 years’ experience overall work experience in Billings environment
• Proficient in Billings Processes
• Proficient in Revenue Cycle Management

Minimum work experience:

• Access SAP reports daily, such as:
  

• Review and analyse reports as a management tool, in order to identify negative trends and implement corrective action.
• Conduct sample audits on patient files to assess accuracy and general quality of the work completed by the billings team; identify trends and deviations and implement corrective action.
• Verify charges completed by Departments and accurately check the final bill on the system.
• Ensure the accurate maintenance of supplier invoices.
• Engage proactively with Reception/Admissions, Case Management, Nursing and Pharmacy staff, where applicable, to ensure the least delay possible in ensuring that invoices are final billed.
• Ensure timeous resolution of queries and complaints and take ownership of issues.
• Collaborate and build relationships with the various Departments in order to process the final bill with as little delay as possible.
• Optimise the billing of products and services provided by the hospital and in line with Company requirements and contractual arrangement with Medical Schemes.
• Comply with cost controls in order to achieve section budget.
• Analyse information and reports to identify trends, discrepancies and inconsistencies for decision-making purposes.
• Escalate trends and deviations to relevant Departments and follow up to ensure corrective action has been implemented

• Diploma in Nursing
• 5 years’ experience overall work experience in Billings environment
• Proficient in Billings Processes
• Proficient in Revenue Cycle Management

• Access SAP reports daily, such as:
  

• Review and analyse reports as a management tool, in order to identify negative trends and implement corrective action.
• Conduct sample audits on patient files to assess accuracy and general quality of the work completed by the billings team; identify trends and deviations and implement corrective action.
• Verify charges completed by Departments and accurately check the final bill on the system.
• Ensure the accurate maintenance of supplier invoices.
• Engage proactively with Reception/Admissions, Case Management, Nursing and Pharmacy staff, where applicable, to ensure the least delay possible in ensuring that invoices are final billed.
• Ensure timeous resolution of queries and complaints and take ownership of issues.
• Collaborate and build relationships with the various Departments in order to process the final bill with as little delay as possible.
• Optimise the billing of products and services provided by the hospital and in line with Company requirements and contractual arrangement with Medical Schemes.
• Comply with cost controls in order to achieve section budget.
• Analyse information and reports to identify trends, discrepancies and inconsistencies for decision-making purposes.
• Escalate trends and deviations to relevant Departments and follow up to ensure corrective action has been implemented