Patient Services Specialist
- Function
- Patient services
- Facility
- Head Office
- Position
- Patient Services Specialist
- Introduction
-
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 the 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 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 behaviour
- 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
- careers@lifehealthcare.co.za
- Closing date
- Friday, January 31, 2025
Internal applicants - Before making an application, you are requested to discuss your application with your line manager. External candidates will also be considered.
Life Healthcare is an Equal Opportunity Employer.
Thank you for your interest in this opportunity. Kindly note that only shortlisted candidates will be contacted. Applicants who have not been contacted within two weeks of the closing date of this advert, should consider their application as unsuccessful.