Bill Auditor

LIFE Healthcare Group; South Africa; On-site; ZAR 300,000 - 400,000; Full time

Job summary

A healthcare institution in South Africa is seeking a Bill Auditor to manage financial and clinical risks. The role requires conducting audits of patient documentation and compiling reports. Ideal candidates should have at least three years of experience in a clinical setting and specialized knowledge in clinical coding. Proficiency in the iMeds/Impilo system is advantageous. This position aims to ensure compliance with healthcare standards and improve audit processes.

Qualifications

• At least three years' experience in a clinical setting.
• 3-5 years of Clinical Coding experience.
• Experience in Case Management.

Responsibilities

• Manage financial and clinical risks by conducting retrospective audits.
• Complete a monthly bill audit report for relevant meetings.
• Maintain relationships with internal customers for compliance.

Skills

Clinical Coding experience

Attention to detail

Problem-solving

Verbal & written communication

Computer proficiency

Education

Grade 12 National Senior Certificate

Professional Nurse qualification

Tools

iMeds / Impilo system

Job description

Overview

A vacancy exists for a Bill Auditor based at Life Peglerae Hospital reporting to the Patient Services Manager, Suzette van Rensburg. 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.

Responsibilities

• 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
• 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 relevant Toolkits 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, report in relevant meetings
• Retrospective clinical auditing of claims and rejected accounts and active engagement with funders
• Equipment invoicing auditing
• Expedite the cash flow management
• Redirect workflow to a single responsible party to manage the funder rejections and relieve case management effort
• Refocus on formulary compliance and trends analysis on increased benefit limitations and protocols
• Analyse trends to identify deviations, report on and influence Stock Controllers & Billing Clerks through presentations and discussions and training in monthly RSRT meetings & bill audit reports

Qualifications and requirements

• Grade 12 National Senior Certificate Nursing Qualification, preferably Professional Nurse with at least three years’ experience
• Clinical Coding experience of at least 3 -5 years.
• Case Management Experience
• Specialized units Nursing experience
• Knowledge of the iMeds / Impilo system will be beneficial
• Knowledge of hospital patient services and billing processes
• Knowledge and understanding of CPT & ICD coding
• Knowledge of Funder contracts, scheme rules, exclusions and benefits
• Knowledge or clear understanding of hospital industry and practices
• Computer proficiency

Competencies

• Attention to detail
• Problem-solving, analysis and judgement
• Verbal & written communication
• Influencing
• Professional & technical proficiency
• Planning & organizing
• Drive and energy
• Excellence orientation
• Ethical behavior
• Building relationships & customer responsiveness
• Organizational awareness

Contact: Email [e-mail]

Closing date: Monday, September 22, 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.