Lifehealth Vacancies – Bill Auditor

Job Description:

A vacancy exists for a Bill Auditor based at Life Groenkloof Hospital reporting to the Patient Service Manager. The successful candidate will be responsible for managing the financial and clinical risks of the business unit by 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 the company objectives and strategy.

Job Responsibilities:

• Verify the presence of a completed checklist on file
• Effective delivery of quality customer care
• Supply proof of completed bill audit reports with additional copies placed in patient files
• Compile and maintain a Bill Audit file containing copies of the Edit accommodation reports, late charges and bill audit reports (per file) – all signed by PSM
• Effective auditing of patient documentation
• Develop and maintain sound relationships with internal customers to achieve co-operation & compliance with audit processes
• Verify carrier code detail on IMEDS to correspond with patient medical aid card
• Verify patient details on IMEDS
• Evaluate data accuracy to identify deviations and make recommendations for corrective action and implement and monitor same
• Audit pre-set number of files according to Life standards, in order to achieve monthly target
• Verify presence of a copies of patient ID and medical aid on file
• Analyse data trends relating to rejections, short payments and Edit accommodations

Job Requirements:

• Problem-solving, analysis and judgement
• Resilience
• Building relationships
• Engaging diversity
• Excellence orientation
• Ethical behaviour
• Influencing
• Verbal & written communication and presentation
• Drive & energy

Qualification & Experience:

• Current SANC registration appropriate to relevant Medical Qualification an advantage
• 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.
• Knowledge and understanding of CPT/CCSA & ICD coding
• Knowledge of hospital patient services and billing processes
• Knowledge of the Life Bill Audit Toolkit, clinical Coding and Life Case Manager Toolkit an advantage

Job Details:

Company: Life Healthcare

Vacancy Type:  Full Time

Job Location: Pretoria, Gauteng, SA

Application Deadline: N/A

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