Credit Controller WCA-Private-Foreign

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Role Summary

The hospital credit controller must be an organized and meticulous person who manage the credit control processes for both local and foreign patients, including Workmen's Compensation (WCA) admissions and private accounts. The Credit Controller will ensure that all outstanding payments are followed up on during patient in progress, payments are collected as required, and records are kept up to date, minimizing hospital debt and maximizing revenue collection.

Key Work Outputs and Accountabilities

Administrative duties

• Ensure that all credit control processes adhere to as per standard operating processes and CSA compliance. Perform general administrative duties related to in hospital credit control, such as filing, record-keeping and updates on the SAP system, and follow ups with patients where required. Agree and Implement action plans to ensure continuous business process and quality improvements.
• Actively participate to optimise collections and contribute achieving hospital DSO.
• Provide a warm and friendly welcome to patients and visitors upon arrival and when addressing their inquiries.
• Answer incoming phone calls promptly and professionally.
• Address patient inquiries or concerns via phone and provide helpful information or referrals.
• Seamless patient journey: create an experience where all aspects of the patient journey are well coordinated, efficient and in a welcoming manner. This entails efficiently resolving patient inquiries, complaints, and any form of engagement, ensuring the patient feels supported and well-informed throughout the entire hospital admission process.

Manage Hospital Credit Control Function

• Ensure compliance to Netcare's standard operating procedures applicable to credit control.
• Manage Hospital Credit Control for Private Patients:
  • Coordinate with patients and persons responsible for the account to resolve any disputes, additional payments etc.
  • Monitor private patient accounts for outstanding balances and initiate timely follow-ups for payments.
  • Follow up on overdue accounts through phone calls, emails, or letters to ensure payments are made within specified terms.
  • Obtain all necessary information from the doctor's room and complete estimations for reception manager and/or Finance manager to sign.
  • Explain and discuss estimated costs letters with patients, retain copies on SAP system and manage related queries.
  • Assist and address all patient and hospital queries regarding walk-ins.
  • Download and print daily private patient PIP report, identify interim balances, make arrangements, and follow up with patient and/or person responsible for payment.
  • Send interim accounts to patient / person responsible for account as per standard operating procedures.
  • Ensure effective communication via the applicable applications i.e. email, SMS (Standard SAP text templates), etc.
  • Adhere to patient privacy protocol in line with the Netcare standard operating procedure.
  • Continuous follow up while patient is in hospital e.g. liaison with relevant parties (including escalation to Reception and Finance manager where risk is identified i.e. when funds are exhausted).
  • Detailed updates on SAP scratch notes on any disputes, arrangements, follow ups, risks relating to private admission.
  • Daily checking of accuracy on case, including but not limited to demographic information, billing accrual, patient information, person responsible information i.e. ID document scanned, correct contact details etc.
• Manage Hospital Credit Control for Medical Aid Patients:
  • Upon admission, and where applicable, process journals i.e. Medical Aid co-payment write off, hospital discounts etc. based on approvals received from Hospital General Manager
  • Ensure follow up on any co-payments during patients stay.
  • Minimize financial risk by promptly addressing discrepancies or issues with co-payment collections and following up with patients or medical aid providers when necessary.
• Manage Hospital Credit Control for International (Foreign) Patients:
  • Ensure the correct insurer has been captured.
  • Validate Letter of Guarantees admitted under correct Insurance Provider on SAP system.
  • Ensure daily validation of limit on Letter of Guarantee and engage with the relevant departments where any information is required and/or outstanding.
  • Contact international funder to revalidate the GOP when funds are exhausted.
  • Liaison with translator to communicate to patients (where applicable).
  • Address all queries from patients under international insurers and assist patients in contacting embassies or relatives to arrange funding.
  • Follow up with billings team to expedite billing for international private cases.
  • Ensure full estimated costs for international private patients have been collected on admission, follow up on any outstanding or additional costs/ balances during hospital stay.
• Manage Hospital Credit Control for WCA/ COID Patients:
  • Manage and monitor daily the COID worklist in SAP and action as per standard operating procedures.
  • Ensure the daily COID admission report is actioned as per standard operating procedures.
  • Obtain all necessary COID documents during patient stay and required for effective registration, adjudication, and submission of claims (including re-opening cases, follow up cases etc.).
  • Obtain and follow up on any outstanding supporting documentation as per standard operating procedures (including but not limited to all Compensation fund, FEMA, RMA and all IOD Insurance Providers)
  • Cooperate with the shared services team to ensure completion of the COID workflow process from registration to final billing and address all related queries.
• General:
  • Ensure that all new births (baby registrations) are registered, and all related queries are dealt with.
  • Continuous follow up with parents to register baby on medical aid and inform relevant parties once authorisation is obtained.
  • Address patient or visitor concerns, complaints, or requests.
  • Ensure payments received were processed on the patient's case. In the case where there is a delay must it be discussed with the Finance manager
  • Manage daily upfront rejections, rectify via the relevant departments, and ensure claims are resent successfully to funders.
  • Take necessary actions to support management with all Private, International and COID-related admissions to avoid disruptions in cash flow.

Maintain Accurate Data and documentation

• Ensure all patient demographic information is accurately captured and in accordance with the Netcare standards.
• Ensure all associated documentation has been collected, filed, and stored as per the Netcare standard operating procedures.

Confidentiality and Privacy

• Protect patient privacy and comply with all privacy regulations as per POPI and Privacy standard operating procedures.
• Ensure that all sensitive information is managed confidentially and securely.

Build and maintain stakeholder relationships

• Attend to patient queries in a professional, empathetic and timely manner.
• Demonstrate visible positive interaction with internal and external stakeholders while upholding the Netcare values.
• Work effectively and co-operatively with others to establish and maintain good working relationships that are mutually beneficial.
• Develop collaborative relationships to help accomplish work goals.
• Participate in monthly meetings to discuss issues and give feedback.

Teamwork

• Actively participate as a member of a team to achieve goals.

Personal and professional development

• Assume responsibility for own personal and professional development.
• Keep up to date with Netcare's evolving policies and procedures.

Skills Profile

Education

Essential

• Grade 12 or equivalent of NQF level 4 Qualification.

Work Experience

Essential

• Minimum 3 years' credit control experience in the healthcare environment.
• Proven ability to provide superior Customer Service Experience.

Knowledge

Essential

• Intermediate computer literacy: Excel, Word and Outlook.
• Comprehensive knowledge of SAP, or relevant software systems used by facility.
• Knowledge of relevant applications e.g. CompEasy, Guarantee of payment letters, estimations etc.
• Working knowledge COID Gazette rules and regulations.
• General understanding of COID/ private/ foreign documents required and billing rules.
• Comprehensive knowledge of admissions and credit control procedures.
• Understand patient confidentiality.

Join the team committed to providing the best and safest health and care.