Patient Administration Manager

The Patient Administration Manager is responsible for leading and coordinating all patient administration functions within the hospital. This includes overseeing patient admissions, discharges, transfers, and records management to ensure efficiency, regulatory compliance, and a high-quality patient experience. The role requires close collaboration with multidisciplinary departments, effective oversight of billing and medical scheme processes, and strict adherence to healthcare regulations such as POPIA and the National Health Act.

Minimum Qualifications and Experience:

• Education: Minimum: Diploma in Health Administration, Healthcare Management, Nursing Administration, Business Management, or related field. Preferred: Bachelor’s degree in health administration, Healthcare Management, Public Health, or Business Administration. ICD-10 coding qualification (Intermediate or Advanced level) from a recognized provider such as Intelli Med or equivalent. Knowledge of CPT/clinical coding systems will be advantageous.
• Experience: Minimum of 5–7 years’ experience in hospital patient administration. Experience within a private hospital environment (Essential). Experience dealing with medical schemes and private funders is required. At least 3 years’ experience managing a patient administration and admissions team within a hospital environment. Proven experience in managing complex hospital operations and patient administration systems. Strong understanding of hospital billing systems, ICD-10 coding, PMB regulations, and private medical aid processes. Exposure to case management functions (e.g. authorizations, length-of-stay monitoring, scheme negotiations). Thorough knowledge of healthcare legislation including POPIA, the National Health Act, HPCSA regulations, and the NHI framework.

Key Responsibilities:

• Patient Administration and Journey Management: Oversee the full patient journey: pre-admission, admission, transfers, discharge, and follow-up. Ensure timely and accurate patient data entry and document collection in compliance with hospital and legal standards. Collaborate with clinical, nursing, pharmacy, and allied health departments to support patient care continuity.
• Systems and Compliance: Ensure optimal use of hospital information systems for registration, billing, and records management. Maintain compliance with POPIA, the National Health Act, Department of Health licensing, and internal audit controls. Coordinate audits and manage relationships with medical schemes, brokers, and other key stakeholders.
• Billing and Revenue Assurance: Monitor and manage patient accounts, authorizations, and medical aid claims to ensure billing accuracy. Work with the Finance Department to safeguard patient revenue and resolve discrepancies promptly. Support tariff reviews and billing updates in the system.
• Reporting and Stakeholder Management: Generate and present regular reports on admissions, outstanding documentation, billing status, and compliance risks. Act as the key point of contact for administrative escalations involving patients, clinicians, funders, and hospital leadership.

Key Skills and Competencies:

• Leadership: Proven ability to lead, motivate, coach, and manage a high-performance team.
• Communication: Excellent verbal and written communication skills for effective stakeholder engagement.
• Analytical Ability: Strong financial acumen with the ability to analyze data and identify operational improvements.
• Technical Proficiency: Advanced computer literacy and familiarity with hospital administration and billing systems.
• Attention to Detail: High level of accuracy in data capture, billing, and financial reporting.
• Organizational Skills: Ability to manage multiple priorities in a fast-paced, high-pressure environment.
• Professional Attributes: Independent, proactive, flexible, detail-oriented, and committed to professional standards.
• Personal Traits: Friendly, approachable, and capable of working both independently and as part of a team.