Vacancies at Melomed Private Hospitals

Description

• Strong quality patient care orientation in order to mitigate risks
• BLS competent
• Must be computer literate and have statistical abilities
• Provide health education to parents and patients
• Supervise and orientate junior staff members and students
• Perform teaching rounds with junior staff members and students
• High energy levels and tolerance for stress/pressure
• Ability to render basic and advance nursing care without supervision
• Delegate duties effectively
• Manage staff in the unit in accordance with BCEA / HR Policies
• Clinical competence
• Good work management, planning and organising skills
• Problem analysis/solving skills and accurate record keeping
• Adaptable and able to work effectively within a multi-disciplinary team and independently
• Strong leadership
• Detail orientated especially with stock management
• Liaison between, doctors, patients and personnel
• Excellent interpersonal and communication skills at all levels
• Ability to make critical clinical decisions
• Work afterhours and weekends as operationally required

Requirements

• Current registration with the South African Nursing Council as a Registered Nurse
• Post Basic Diploma or Equivalent in Critical Care General
• Proven experience as a Shift Leader or Deputy Unit Manager in an ICU setting
• Experience in the Cardiothoracic Speciality will be an advantage
• A minimum 5 years’ experience in the relevant specialty
• Excellent interpersonal, communication and administrative skills
• Excellent Leadership qualities and mentoring skills
• Accurate record keeping and the management of stock
• Commitment to initiate and implement continuous improvement projects
• Excellent MS Office computer skills, i.e. Outlook, Word, Excel, etc.
• Knowledge of the Kronos System

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Description

• Manage the Admin Department and processes with regards to non-releases
• Manage the Credit Control queries
• Manage Case Manager updates and escalations for Medical Aids
• Ensure accurate ICD 10 and CPT Coding
• Analysis of Billing errors
• Managing Fixed Fee Contracts with Medical Aids
• Management of staff
• Daily and Monthly reporting to Hospital Manager and Head Office regarding Admin stats
• Month end finalisation of files
• Private patients’ quotations, Financial Risk Management and daily banking
• Auditing of Hospital folder greater than 10K
• Auditing coding on claims and checking if co-morbidities have been captured
• Auditing of clinical data submitted to the Medical funder / aid / institute
• Ensuring that the high cost medication process has been followed
• Responsible for the security and accuracy of the patient records
• Liaise with the relevant stakeholders regarding claims, billings etc. and ensure that all claims / queries have been actioned by the relevant staff members within the Department
• Oversee and streamline the billing processes
• Plan and implement quality assurance for all billing and case management processes
• Conduct routine staff meetings regarding billing planning and implementations
• Assist in standardising the methods in which work will be accomplished
• Ensure that the activities of the billing operations are conducted in a manner that is consistent with overall department protocol and follow Melomed healthcare regulations, guidelines and requirements, review departmental procedures and evaluate the effectiveness of personnel
• Understand and remain updated with current coding and billing regulations, compliance requirements and scheme rules changes / requirements
• Provide, oversee, and/or coordinate the provision of training for new and existing staff on applicable operating policies, protocols, systems and procedures, standards, and techniques
• Checking of daily reports
• Ward report – ensure all patients are allocated to a Case Manager and updated accordingly
• Non–Release - ensure all discharge folders are received
• Medikredit Control Panel - ensure all claims are accurate and submitted accordingly
• Checking daily Theatre slates
• Follow up on daily, weekly and monthly queries
• Assist staff members with escalation of claims, queries, billings and LOM requests

Requirements

• Grade 12
• An applicable tertiary qualification will be an advantage
• A minimum 3 – 5 years Management or Supervisory experience
• Knowledge of ICD 10 and CPT Coding
• Knowledge of Medical Aid Rules and Fixed Fee Contracts with Funders
• In depth knowledge and understanding of Private Hospital Billings guidelines
• General accounting knowledge and financial skills
• Ability to work well under pressure and function independently
• Excellent computer skills