Rejections and Billing Quality Manager

As the leading medical recruitment agency in South Africa, our client has an exciting opportunity for a Rejections and Billing Quality Manager to be based in Bryanston.

The client

Our client is a well-established private hospital group with a strong footprint in South Africa. They are recognised for their commitment to clinical excellence, operational efficiency, and high standards in patient care and revenue management.

The opportunity

This role is responsible for overseeing billing quality and rejection management across the hospital group, ensuring revenue is protected through accurate billing, proactive rejection prevention, and continuous process improvement. The position plays a critical role in driving compliance, training, and performance across billing teams.

Key responsibilities

• Manage and oversee billing quality and rejection processes across the hospital group

• Analyse rejection trends and implement corrective and preventative strategies

• Ensure compliance with medical schemes, coding standards, and internal policies

• Conduct regular audits of billing and claims to identify risk and improvement areas

• Develop, implement, and maintain billing quality control frameworks

• Provide guidance, coaching, and training to billing and accounts staff

• Liaise with internal stakeholders, funders, and external partners to resolve complex billing issues

• Prepare reports and insights for senior management on billing performance and rejections

Requirements

• Diploma or Degree in Nursing, Healthcare Administration, Business Administration, or Revenue Cycle Management

• Strong understanding of hospital operations, patient admissions, case management and billing processes

• Clinical coding certification not required but beneficial

• Minimum 5 years’ experience in patient admin, billing, or revenue cycle in a private healthcare environment

• Proven track record in managing medical aid and private claim rejections

• Experience working across multiple facilities or regions preferred

• Working knowledge of Medikredit or similar healthcare billing/electronic claims submission systems

• Proficiency in using Health Management Information Systems (HMIS)

• Strong knowledge of National Hospital Network reimbursement models, funder contracts and network, funder rules, co-payments and exclusions

• Knowledge of healthcare regulations and policies

• Proficiency in using accounting software and MS Office, particularly Excel

Benefits

• Opportunity to join a reputable and growing private hospital group

• Strategic role with real impact on revenue and operational performance

• Professional and collaborative working environment

• Career growth and development opportunities

Location: Bryanston

Does this sound like the right role for you? Click here to start your application

If this vacancy is closed or if you have any questions, please contact caron@medipath.co.za

Please be advised that you will be contacted by Medipath Healthcare Recruitment within 14 days should we wish to proceed with your application. Similarly, if you are not contacted by Medipath Healthcare Recruitment, please accept your application as unsuccessful. Your CV will automatically be added to our database and we could be contacting you should a suitable position arise.