BILL AUDITOR

• Responsibilities

Audit inpatient files – with particular attention to long-stay and high-value cases – to mitigate financial risk

• Analyse trends in funder rejections, short payments and late charges, and report findings
• Ensure all billing checks are closed before accounts are finalised and submitted to funders
• Maintain complete bill-audit files and submit a monthly bill audit report to management
• Evaluate data accuracy, identify deviations and recommend, implement and monitor corrective actions
• Monitor compliance with patient-services processes and present findings at monthly risk meetings
• Requirements
• Nursing Diploma or Degree; registered with the Nursing and Midwifery Council of Botswana
• Minimum 3 years’ experience in hospital billing or bill auditing
• Knowledge and understanding of CPT & ICD coding
• Knowledge of hospital patient services, billing and case-management processes
• Knowledge of funder contracts, scheme rules, exclusions and benefits
• Understanding of the private hospital industry and practices
• Computer proficiency (MS Office)