Patient Administrator - Billing - Somerset West

The Patient Administrator will improve operational efficiency, optimise financial performance, and enhance patient experiences. The administrator will be responsible for all aspects of patient administration–admission, medical aid communication, authorisation, billing and general administrative tasks.

The team member will have an obligation to clearly communicate with patients, assist the hospital in identifying financial and reputational risk at the frontline (Admissions) and ensure quality admissions by safeguarding correct, accurate, complete and relevant patient data; ensure data integrity for use throughout the admission to receipt value chain and improve patient experience.

The team member will further be responsible for admissions and pre-admissions of patients, handling payments of private patients; co-payments, admit and discharge patients in a professional, friendly and efficient manner, whilst creating and maintain goodwill with all Doctors and their Reception team.

The team member will be required to work with integrated systems and software across functions.

• Compiling, quality checking and processing of daily billing.
• Find resolutions to billing queries pro-actively
• Ensure invoices are done as close as possible to real time processing, and with the applicable supporting documentation.
• Ensuring billing ties in with accurate stock control.
• Prepare and submit billing reports and perform revenue assurance checks to avoid revenue leakage
• Liaise with all department to ensure accurate and complete billing
• Perform month end processing Financial Administration
• Check if patient has any outstanding previous accounts.
• Assist private patients by preparing the Pre-payment estimate according to hospital guideline using the approved documentation. All estimates to be signed off by Hospital Manager or her designate.
• Identify financial risks pro-actively and communicate these to the Credit Controller.
• Collect payments according to protocols and prepare financial registers daily, accountable for receipting functions as per policy.
• Weekly banking on prescribed documentation according to protocol.
• Maintain a well-run, professional and patient focussed admission environment.
• Manage the accuracy of the admission process and the prevention of potential risk factors.
• Synergy and teamwork–working closely with credit controllers, nursing team, stock controllers and doctors.
• Assist patients to accurately complete appropriate forms and documents for the required information.
• Capture and records patient medical and personal information on the Hospital system in a professional, friendly and timeous manner, focusing on patient and visitor’s needs
• Manage the risk for the hospital by adhering to all related protocols.
• Handling money and receipting according to protocol
• Collection of co-payments, private fees when applicable as well as related documentation.
• Performing general administration duties involved in the pre-admission of patients.
• Billing and releasing of accounts daily within 24 hours.
• Ensuring submission of correct accounts to funders via platforms provided
• Manage and correct all rejected claims daily
• Drive pre-admissions, admissions and confirmations to achieve quality admissions that minimise risk and maximise revenue collections.
• Assist the Credit Controller in ensuring that the medical aid tariff and option changes are implemented through Messages, alerts, to minimise confusion and uncertainties during the change-over period at year end.
• Assist in resolving patient complaints according to Best Practices and monitor patient satisfaction in an effort to drive action plans for improvement
• Communicate effectively with key role players in order to enhance quality management.
• Identify and rectify non-compliance with business policies and procedures.
• Share information of patients and procedures with theatre and wards for theatre and bed planning with accurate information about gender, age, exact description of diagnosis.
• Patients are requested to arrange authorisations–the hospitals assist when requested to do so.
• Update procedures and coding with funders, as and when required.
• Capturing of notes on the system with regards to any of the above is crucial as all parties involved needs to know what was done/approved/arranged
• Provide efficient and professional telephone services
• Assist patients in accurately completing appropriate forms, and document all information in accordance to internal policies and procedures.
• Direct all patients to the appropriate location, services and appropriate nursing or medical professional.
• Ensure patient confidentiality at all times in line with protocol NHA & Poppi Act
• Ensure that the reception area is always neat and tidy.
• To refer all emergency cases to the nurse’s station according to protocol.
• Assist patients with basic account queries and escalate as necessary.
• Collect all co-payments and private account balances according to health policies and procedures.

• Grade 12 or equivalent NQF level 4 qualification.
• A National Diploma or Relevant NQF 6 qualification in Administration will be advantageous.
• A minimum of 2-4 years Hospital Healthcare industry experience.
• A minimum of 2-4 years’ experience in the admissions processes in a private hospital environment.
• Billing background is essential.
• Previous experience in pre-admission, admission; confirmation department essential
• Basic working knowledge of ICD and CPT coding essential
• Knowledge of Medical Aid rules, limits and processes essential.
• Proven track record and dedication to quality and superior customer service.
• Understanding the Trimed system and Trimed management reports.
• Sound knowledge of NHN & ADV Billing and Tariff guidelines.
• Knowledge of Alternative Re-imbursement tariffs essential.
• Strong systems knowledge and proficiency in business processes, compliance and governance.
• Relevant computer proficiency (Microsoft Office).
• Good command of English, written and oral.
• Additional language skills would be advantageous
• Good verbal, written and interpersonal communication skills in English.
• Ability to work well under pressure and to maintain effectiveness during changing conditions
• Ability to work effectively and co-operatively with others by establishing and maintaining good working relationships co-workers, stakeholders, clients of the company.
• Excellent planning, organising and control / follow-up skills are essential
• Must be customer care oriented
• Must be able to use initiative to overcome day to day operational roadblocks e.g. systems down.
• Attention to detail and accuracy
• High level of professionalism.
• High level of Logical thinking.
• Ability to meet deadlines.
• Deadline driven.
• Resilience
• Engaging diversity
• Influencing
• Drive & energy
• Excellence orientation.
• Ethical behaviour and honesty.
• In the event of any physical or psychological limitation that may impair the employee’s ability to perform the required job function, the employee must consult the employer for reasonable accommodation.
• Professional flexibility in working hours while supporting daily business hours.
• Will interact with internal and external stakeholders through several different means.