HEAD, BUSINESS OFFICE

Job Description:

1. STRATEGIC LEADERSHIP & DEPARTMENT MANAGEMENT

• Lead, direct, and manage the overall operations of the Business Office.
• Develop departmental strategic plans aligned with the hospital's vision, mission, and corporate objectives.
• Ensure efficient utilization of manpower, financial resources, and operational systems.
• Review departmental structure, manpower requirements, and succession planning to support hospital growth.
• Drive a culture of operational excellence, accountability, and continuous improvement.

2. REVENUE CYCLE MANAGEMENT

• Oversee the hospital's complete Revenue Cycle Management, including:
  • Patient Registration
  • Admission & Discharge
  • Accident & Emergency Registration
  • Bed Management
  • Guarantee Letter Verification
  • Patient Payment
  • Chief Cashier
  • Inpatient Billing
  • Credit Administration
  • Case Review
  • Insurance & Corporate Billing
• Ensure timely patient registration, billing finalization, insurance claim submission and collection of outstanding receivables.
• Monitor departmental revenue performance and implement corrective actions to minimize revenue leakage.
• Ensure accurate charging practices and compliance with hospital billing policies.

3. OPERATIONAL MANAGEMENT

• Oversee daily Front Office and Back Office operations.
• Monitor departmental workload, manpower allocation and productivity.
• Ensure departmental Service Level Agreements (SLAs) are achieved.
• Coordinate with Nursing, Medical Services, Finance, Pharmacy, Corporate Sales, and other departments to facilitate seamless patient flow from admission to discharge.
• Resolve operational issues and implement improvement initiatives.

4. FINANCIAL GOVERNANCE & INTERNAL CONTROL

• Ensure compliance with financial policies and internal controls.
• Monitor:
  • Daily revenue collection
  • Cash reconciliation
  • Refunds
  • Credit Notes (CN)
  • Debit Notes (DN)
  • Cash variances
  • Deposits
  • Outstanding receivables
• Strengthening financial governance to safeguard hospital revenue.
• Ensure compliance with delegated financial authority.

5. AUDIT, REVENUE ASSURANCE & COMPLIANCE

• Lead and coordinate Business Office internal and external audits.
• Prepare audit reports, management responses and corrective action plans.
• Monitor implementation of audit recommendations.
• Ensure compliance with:
  • Hospital Policies
  • Standard Operating Procedures (SOP)
  • Ministry of Health requirements
  • PDPA
  • MSQH Standards
  • Internal Audit requirements
  • Group Business Office requirements
• Monitor departmental risks and implement mitigation plans.

6. ROBOTIC SURGERY AUDIT & REVENUE ASSURANCE

• Lead the hospital's Robotic Surgery Audit programme.
• Review robotic-assisted surgical cases to ensure compliance with insurer requirements and hospital policies.
• Verify robotic declarations against:
  • Consent Forms
  • Operating Theatre Records
  • Insurance submissions
  • Patient Bills
  • Clinical documentation
• Identify revenue leakage, billing discrepancies, and insurance compliance issues.
• Coordinate corrective actions with Consultants, HIMs, Operating Theatre, Billing and insurers.
• Prepare monthly robotic audit reports for Hospital Management, Group Business Office and insurance audits.
• Monitor implementation of corrective actions arising from robotic audit findings.

7. CONSULTANT FEES COMMITTEE

• Serve as Secretary to the Consultant Fees Committee.
• Coordinate Consultant Fees Committee meetings.
• Prepare:
  • Meeting agenda
• Record and circulate meeting minutes.
• Monitor implementation of committee decisions.
• Maintain the Fees Committee Action Tracker.
• Prepare reports on:
  • New charge codes
  • Charge code revisions
  • Hospital pricing
  • Consultant fee revisions
  • Financial impact analysis
  • Doctor Orientation

8. REPORTING & BUSINESS ANALYTICS

• Prepare monthly Business Office performance reports.
• Analyse operational and financial performance trends.
• Monitor departmental KPIs including:
  • Admission Turnaround Time
  • Billing Turnaround Time
  • GL Turnaround Time
  • AUC status
  • Ageing
  • Bed occupancy
  • Unbilled cases
  • Unsubmitted bills
  • Outpatient waiting time in the pharmacy
  • Customer complaints
  • Late charge
• Present Business Office performance during Management Meetings.
• Recommend strategic improvement initiatives.

9. LEADERSHIP & PEOPLE DEVELOPMENT

• Lead, mentor and develop Senior Executives and Business Office staff.
• Conduct performance management and staff competency development.
• Promote teamwork, innovation, and employee engagement.
• Review staffing requirements and succession planning.
• Ensure adequate staff training and competency assessment.

10. CUSTOMER EXPERIENCE

• Promote excellent customer service throughout the Business Office.
• Review patient complaints and implement service recovery initiatives.
• Improve patient journey through efficient financial clearance and discharge processes.

11. STAKEHOLDER MANAGEMENT

• Establish effective working relationships with:
  • Operations Manager
  • Chief Executive Officer
  • Finance Department
  • Nursing Services
  • Medical Services
  • Pharmacy
  • Marcom
  • Information Technology
  • Human Resources
  • Insurance Companies
  • Third Party Administrators (TPA)
  • Consultants
• Represent the Business Office in hospital committees and cross-functional projects.

12. DIGITAL TRANSFORMATION & PROCESS IMPROVEMENT

• Lead digital transformation initiatives within the Business Office.
• Promote automation and optimisation of business processes.
• Improve utilisation of Hospital Information Systems (HIS), e-Billing, e-Invoicing and digital workflows.
• Benchmark Business Office practices against KPJ and industry best practices.

13. QUALITY & CONTINUOUS IMPROVEMENT

• Lead Lean, Kaizen, 5S and Continuous Quality Improvement (CQI) initiatives.
• Ensure readiness for accreditation surveys and regulatory inspections.
• Drive departmental innovation to improve operational efficiency and patient experience.

14. OTHER RESPONSIBILITIES

• Perform any additional duties assigned by the Operations Manager or Chief Executive Officer.
• Lead special projects and hospital strategic initiatives.
• Ensure ethical practices, good governance, and compliance throughout the Business Office.

Job Requirements:

Education:
Degree or Masters in any related field

Knowledge and Experiences:
▪ Minimum 5 years relevant experience in a hospitality environment.
▪ Excellent interpersonal & communication skills.
▪ Excellent in both written and verbal (Bahasa Malaysia/English)
▪ PC Literate- Computer Proficiency
▪ Familiar with 13th Schedule
▪ Good reputation with insurance personal

Skills & Competencies:
• Strategic Leadership
• Healthcare Operations Management
• Revenue Cycle Management
• Financial Management
• Revenue Assurance
• Healthcare Billing & Insurance
• Audit & Compliance Management
• Pricing Governance
• Risk Management
• People Leadership & Coaching
• Change Management
• Customer Experience
• Stakeholder Management
• Data Analytics & Business Intelligence
• Process Improvement (Lean / Kaizen / CQI)
• Healthcare Information Systems (HIS, BMS, e-Billing, e-Invoicing)
• Project Management
• Decision Making & Problem Solving
• Communication & Presentation Skills
• Ethical Leadership & Corporate Governance

Special skills required:
▪ A self-starter with initiative and the ability to work independently.
▪ Effectively interacts at all levels.
▪ Works beyond normal hours in support of projects or other assignments.

Personal attributes:
• High level of integrity, honesty, trustworthiness, and ability to maintain confidentiality.