Tariff File Manager and Patient Billing Analyst

PURPOSE OF POSITION

• To provide strategic billing, revenue analysis, and reporting support across the Group.

KEY PERFORMANCE AREAS

Strategic Leadership

• Provide guidance on medical aid scheme rules.
• Deliver billing analytical support to the Group General Manager, CFO, and senior management team.
• Investigate and resolve complex billing, claims, and system-related queries.

Revenue & Billing Analysis

• Analyse efficiency reports from medical aids and investigate billing variances and cost outliers.
• Prepare review group revenue, doctor revenue, age analysis, and admission statistics.

Tariff & Contract Management

• Develop and maintain tariff schedules for multiple healthcare facilities and funding models.
• Update new ARMS contracts, medical aid agreements, and annual tariff updates.
• Coordinate tariff loading, validation, and audit processes with system providers and auditors.

Reporting & Data Management

• Prepare monthly revenue and admission stats reports.
• Generate ad hoc business intelligence reports for hospital management and pharmacy operations.
• Maintain and distribute pricing files, coding updates, and system-related reports.
• Ensure accuracy and integrity of data used in executive decision-making.

Systems & Process Improvement

• Support and troubleshoot Hospital Management System (HMS) billing and claims issues.
• Resolve complex medical aid, Delta9, MediKredit, and case management queries.
• Implement system enhancements and roll out process changes across the group.
• Develop and maintain standard operating procedures (SOPs).

Staff Management & Training

• Manage the patient file archiving and records management process.
• Ensure compliance with patient confidentiality and information protection requirements.
• Train and mentor staff on key billing and reporting processes.
• Crosstrain team members to ensure business continuity.

COMPETENCIES (The following will be advantageous)

MINIMUM REQUIREMENTS

(Educational Qualifications & Experience)

• Bachelor of Commerce (BCom) degree or equivalent qualification.
• 5 years' experience in Data Analytics.
• 2-3 years' experience in a junior management role.
• Experience of working within a team and ensuring delivery targets are met on time and to budget.
• Experience in a Hospital environment preferable.
• Experience of patient administration systems would be advantageous.

SKILLS

(Practical & Technical)

• Strong knowledge of private hospital billing processes, medical aid schemes and Tariff Structures, and healthcare revenue cycle management.
• Advanced proficiency in Microsoft Excel and healthcare reporting systems.
• Experience with hospital management systems, patient administration systems, and healthcare billing platforms will be advantageous.
• Strong analytical, financial, and statistical reporting skills, with the ability to interpret complex data and provide actionable insights.
• Previous experience in staff supervision, training, and performance management will be advantageous.
• Knowledge of Delta9 and other healthcare business applications would be beneficial.

BEHAVIOURAL ATTRIBUTES

(Personality Characteristics)

• Integrity and professionalism
• Accountability
• Initiative and self-motivation
• Adaptability and resilience
• Team player
• Customer-focused
• Strong work ethic
• Confidentiality and discretion