Accounts Controller – Medical Billing and Revenue Tasks
Mediclinic vacancies
Available Locations:
Randburg, Gauteng
Job Description
Job Summary
Mediclinic is seeking a detail‑oriented Accounts Controller – Medical Billing & Revenue to own the end‑to‑end revenue cycle: from charge capture and claim submission to payment posting, reconciliation, and denial resolution. You will safeguard revenue integrity, shorten Days Sales Outstanding (DSO), improve first‑pass claim acceptance, and ensure full compliance with payer contracts, accounting standards, and healthcare regulations.
Key Responsibilities
- Revenue Cycle Ownership
- Oversee patient billing, coding validation, claim generation, and electronic/paper submissions.
- Monitor outstanding AR, prioritize follow‑ups, and drive collections to target.
- Payment Posting & Reconciliation
- Post remittances (ERA/EOB), reconcile variances, and escalate underpayments/write‑offs for approval.
- Perform month‑end revenue reconciliations between EMR/RCM, GL, and bank statements.
- Denials & Audit Management
- Analyze denial trends, implement corrective actions with coding/clinical teams, and reduce denial rates.
- Prepare documentation for internal/external audits and ensure adherence to audit recommendations.
- Compliance & Controls
- Ensure compliance with ICD‑10, CPT/HCPCS, payer guidelines, SOX/IFRS/GAAP (as applicable).
- Maintain strong internal controls over revenue recognition, refunds, credit balances, and write‑offs.
- Reporting & Insights
- Produce daily/weekly/monthly dashboards: DSO, clean claim rate, denial rate, recovery %, bad debt, cash collections.
- Partner with Finance, Clinical Operations, and IT to streamline processes and automate reconciliations.
- Stakeholder & Vendor Management
- Liaise with payers, TPAs, clearinghouses, and collection agencies to resolve escalations.
- Review payer contracts and fee schedules; flag rate discrepancies and ensure timely updates in systems.
- Process Improvement
- Lead or support RPA/automation, EDI optimization, and standardization of SOPs and SLAs across sites.
Required Skills and Qualifications
- Bachelor’s degree in Accounting, Finance, Commerce or related field.
- Solid understanding of end‑to‑end medical billing / revenue cycle management (RCM).
- Proficiency with EMR/RCM platforms (e.g., Epic, Cerner, Athenahealth) and ERP/GL systems (e.g., SAP, Oracle, Netsuite).
- Strong grasp of ICD‑10, CPT, HCPCS coding frameworks and payer adjudication logic.
- Hands-on experience with ERA/EOB posting, AR aging, payer reconciliation, and denial analytics.
- Advanced Excel/Google Sheets (pivot tables, lookups, Power Query/Power Pivot preferred).
- Ability to read and interpret payer contracts, remittance advices, and reconciliation reports.
- Excellent analytical, numeracy, and stakeholder communication skills.
Experience
- 3–6 years of progressive experience in medical billing, revenue accounting, or AR control within a hospital, clinic network, TPA, or healthcare BPO.
- Demonstrated success in reducing DSO, improving first-pass acceptance, and lowering denial rates.
- Prior audit exposure (internal/external) and process automation experience is a plus.
- Knowledge of IFRS/GAAP revenue recognition (healthcare context) preferred.
Working Hours
- Standard: 40 hours per week (e.g., Monday–Friday, 9:00–18:00).
- Flexibility to work payer-driven or month-end close hours, and occasional weekends during close/audits.
- If supporting international markets, ability to align with shift windows (US/ME/Europe) as required.
Knowledge, Skills & Abilities (KSAs)
- Knowledge: Revenue recognition principles, payer reimbursement methodologies (capitation, DRG, per‑diem, fee‑for‑service), credit balance management, and regulatory frameworks (HIPAA/GDPR/local equivalents).
- Skills: Data reconciliation, root‑cause analysis, variance investigation, financial modeling, dashboarding/BI (Power BI/Tableau).
- Abilities: Prioritize high-impact AR buckets, influence cross-functional stakeholders, draft & enforce SOPs, and operate effectively in high-volume environments.
Benefits (tailor to your policy)
- Competitive salary with performance-based incentives tied to AR/DSO/denial KPIs.
- Health insurance for self and dependents.
- Retirement/Provident Fund/gratuity as applicable.
- Paid time off, sick leave, and parental leave.
- Learning & development budget for certifications (e.g., CRCR, HFMA).
- Hybrid/remote work flexibility and modern productivity tools.
Why Join Mediclinic
- Be a key custodian of revenue integrity in a growing, technology-forward healthcare group.
- Drive data-led decision making and automation across the revenue cycle.
- Collaborate with clinical, operations, finance, and tech teams to shape best-in-class processes.
- Clear career progression into Revenue Cycle Lead/Manager, Finance Controller, or FP&A roles.
How to Apply
- Send your CV and a brief cover letter highlighting relevant RCM/AR achievements (e.g., % DSO reduction, denial rate improvements) to [careers@mediclinic.com] (replace with the real address).
- Use the subject line: “Accounts Controller – Medical Billing & Revenue | Your Name”.
- Attach or include key metrics, tools used, and process improvements you led.
- Shortlisted candidates will complete a case exercise on AR aging & denial analytics, followed by panel interviews.