Billings Clerk – Herolim Private Hospital

Job Description

Herolim Private Hospital is seeking a diligent and detail-oriented Billings Clerk to join our Patient Administration team. This is a vital role within our hospital’s operations, responsible for ensuring the accurate and timely billing of all patient services to medical aids. The successful candidate will play a key part in maximizing revenue collection by meticulously gathering, coding, and transmitting patient care information. You will report directly to the Patient Administration Manager.

Key Responsibilities

The main duties and critical outputs for this position include, but are not limited to:

• Accurately applying ICD-10 codes, CPT codes, all relevant medical aid tariffs, and billing rules to patient accounts.
• Processing daily billing for all inpatient and outpatient accounts, including those for length of stay (LOC), equipment, and stock.
• Ensuring the timely closure and release of accounts for patients who have been discharged.
• Monitoring the receipt of discharged patient files and reporting any trends of delays to management.
• Assisting with the final audit of all patient accounts before they are released for payment.
• Monitoring the account release system to guarantee complete submission to medical schemes.
• Liaising closely with Ward staff, the Pharmacy, and Theatre departments to obtain correct and complete information, such as CPT codes, stock codes, equipment details, theatre time, procedure types, and anaesthetic gases.
• Maintaining regular and effective communication with all members of the multi-disciplinary healthcare team.
• Ensuring the complete and efficient billing of all patient accounts that require prosthesis details.
• Proactively identifying potential risk areas in the billing process and providing constructive feedback to management.

Requirements

To be considered for this role, candidates must meet the following criteria:

• Grade 12 or an equivalent NQF level 4 qualification.
• A nursing qualification will be a strong advantage.
• Previous hands-on experience in a hospital billings or medical accounts department is essential.
• Solid knowledge of the private healthcare industry and a clear understanding of Medical Scheme rules and regulations.
• Proficiency in ICD-10 coding.
• Working knowledge of a Hospital Information System (HIS).
• Strong computer literacy skills.

Personal Competencies

The ideal candidate will demonstrate the following attributes:

• Strong collaboration and relationship-building skills.
• Resilience and the ability to work under pressure.
• A commitment to engaging with and respecting diversity.
• Excellent verbal and written communication and presentation abilities.
• Effective planning and organizational skills.
• A high level of customer responsiveness and service orientation.
• Strong organizational awareness.
• A dedication to excellence and quality in all tasks.
• Unwavering ethical behaviour.
• A commitment to maintaining technical and professional knowledge.
• Adaptability to a changing environment.
• Meticulous attention to detail.

Department

Administration