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Business Consultant

South Africa Nelson Mandela Bay (Port Elizabeth / Uitenhage), South Africa - Eastern Cape ZA, South Africa
Closing date
Jun 24, 2024

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Job Role
Contract Type
Full Time
Our client is looking for an experienced Business Consultant to join their firm Requirements
  • Experience as a business consultant in the relevant field.
  • At least 3 to 5 years of experience in business consulting with a focus on healthcare services
  • Matric
  • Bachelor's degree in business/marketing or a related field will be advantageous
  • Computer experience is required
  • Own transport is essential
  • RE1 Qualification
  • FAIS Accredited
  • Willingness to work extended and flexible hours and may be required to travel to Johannesburg.
Job Duties
  • Negotiating Contracts: You would negotiate contracts with insurance companies to ensure favorable terms for the medical center. This includes negotiating reimbur to sement rates, coverage policies, and contract terms.
  • Analyzing Insurance Plans: You would analyze various insurance plans available in the market to determine which ones would be most beneficial for the medical center and its patients. This involves evaluating factors such as reimbursement rates, patient coverage, and administrative requirements.
  • Provider Relations: Building and maintaining relationships with insurance providers is crucial. You would serve as the main point of contact between the medical center and insurance companies, addressing any issues that arise and ensuring smooth communication.
  • Billing and Reimbursement Management: You would oversee the billing and reimbursement process to ensure that the medical center receives proper payment for the services rendered to patients. This may involve resolving billing disputes, managing denials, and optimizing revenue cycle processes.
  • Compliance: Ensuring compliance with relevant healthcare regulations and insurance industry standards is essential. You would stay updated on changes in regulations and policies that may impact insurance contracts and reimbursement practices.
  • Data Analysis and Reporting: Analyzing data related to insurance claims, reimbursement rates, and payer mix can provide valuable insights for decision-making. You would be responsible for generating reports and analyzing data to identify trends and opportunities for improvement.
  • Educating Staff: You may be involved in educating medical center staff on insurance-related matters, such as coding and billing practices, insurance verification procedures, and documentation requirements.
  • Strategic Planning: Working with senior management to develop strategic initiatives aimed at maximizing revenue, minimizing denials, and optimizing the medical center's financial performance.
  • Problem Solving: Resolving issues related to insurance claims, denials, and reimbursement discrepancies requires problem-solving skills and attention to detail. You would work to identify root causes of problems and implement solutions to prevent recurrence.
  • Market Analysis: Conducting market analysis to identify opportunities for growth and expansion, as well as potential threats from competitors and changes in the healthcare landscape.

R10 000 to R20 000 plus commission (depending on experience)

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