Bill Auditor

Life Healthcare Group; Gauteng; On-site; ZAR 300 000 - 400 000; Full time

Job summary

A leading healthcare provider seeks a Bill Auditor to manage financial and clinical risks by conducting audits of patient documentation. The role involves analyzing data trends, ensuring compliance with hospital billing processes, and maintaining quality customer care. Applicants should have a relevant diploma or degree and strong problem-solving skills.

Qualifications

• Current SANC registration relevant to the qualification.
• Knowledge of clinical coding and hospital billing processes.

Responsibilities

• Conduct audits of patient documentation and billing information.
• Evaluate data accuracy and recommend corrective actions.
• Monitor compliance with audit processes and report findings.

Skills

Attention to detail

Problem-solving

Analysis

Effective communication

Education

Diploma or degree in Nursing

Diploma or degree in Physiotherapy

Diploma or degree in Clinical Associates

Diploma or degree in Paramedics

Tools

Life Bill Audit Toolkit

Life Case Manager Toolkit

Job description

A vacancy exists for a Bill Auditor based at Life Flora Hospital, reporting to the Patient Services Manager, Trust Pandor.

The successful candidate will be responsible for managing the financial and clinical risks of the business unit by conducting retrospective audits of patient documentation.

This includes identifying areas of weakness, recommending corrective actions, and monitoring their implementation to support the company's objectives and strategy.

Critical Outputs

1. Effective delivery of quality customer care: Evaluate data accuracy to identify deviations, recommend corrective actions, and monitor their implementation. Analyze data trends related to rejections, short payments, and edit accommodations.
2. Develop and maintain sound relationships with internal customers: Ensure cooperation and compliance with audit processes. Maintain a Bill Audit file with relevant reports, signed by the Patient Services Manager. Provide proof of completed bill audit reports, with copies in patient files.
3. Effective auditing of patient documentation: Audit a preset number of files monthly according to standards. Verify the presence and accuracy of checklists, patient IDs, medical aid details, and billing information. Ensure correct coding, billing, and discharge details. Complete audit templates and submit monthly reports.
4. Effective auditing of hospital operational processes: Verify statistics and analyze trends on rejections, short payments, late charges, and edit accommodations.
5. Effective monitoring of patient services process compliance: Identify deviations, report findings, and facilitate corrective actions through presentations and discussions.

Minimum Requirements

• Diploma or degree in Nursing, Physiotherapy, Clinical Associates, Paramedics, or related fields covering Anatomy, Physiology, Pathophysiology, and Microbiology.
• Current SANC registration relevant to the qualification.
• Knowledge of the Life Bill Audit Toolkit, clinical coding, and Life Case Manager Toolkit is advantageous.
• Understanding of hospital billing processes, CPT / CCSA & ICD coding, and funder contracts.
• Proficiency in computer skills.

Competencies

• Attention to detail, problem-solving, analysis, and judgment.
• Effective verbal and written communication, influencing skills, and personal integrity.
• Planning, organizing, relationship building, drive, process orientation, independence, conflict management, and self-management.

Email applications to [application email].

Internal applicants are advised to discuss their application with their line manager prior to applying.

External candidates are also encouraged to apply.

Life Healthcare is an Equal Opportunity Employer.

Only shortlisted candidates will be contacted.

If you do not hear within two weeks post-closing, consider your application unsuccessful.