Posted: 2024-08-28, Closing: 2024-09-10 Location: Free State, Welkom DescriptionA vacancy exists for a Case Manager, reporting to the Patient Administration Manager. The position's primary responsibilities include efficient patient case management and the delivery of an efficient and professional service to the internal and external customers. The successful candidate will be goal oriented with strong customer, quality, and performance focus.Critical OutputsEnsure that pre-admission and pre-authorization information is accurate and in accordance with hospital and funder procedures.Carry out clinical coding in accordance with CPT/CCSA and ICD requirements.Daily ward rounds for effective clinical update communication and timeous follow up with medical aids.Maintain patients' clinical status in accordance with funder approval requirements for the duration of hospitalization; keeping patients informed and managing the entire hospital stays' financial risk.Provide complete and accurate updates and discharge information of all accounts.Maintain accurate accounts of all admissions.Handle patient files in accordance with hospital procedures.Timeous electronic submission of accounts and follow up on short payments arising from case management related issues.Ensure the adherence of hospital staff to funder rules and coding procedures.Keep well informed on legislation pertaining to funders and related Health Care matters.RequirementsHigh school matric certificate.Registered as a healthcare professional RN/EN/ILS/BLS/Pharmacist – advantages.3 – 5 years' experience in clinical coding, private hospital case management and Medical Aid administration procedures.Knowledge of hospital billing, funder contracts and tariffs would be an advantage.Have sound computer literacy skills and working knowledge of MS Office, Word and Excel.Excellent communication skills and the ability to form and build strong relationships & partnerships with internal & external stakeholders.Excellent negotiation skills & the ability to interact with tact and diplomacy.SkillsCollaboration/ Relationship BuildingAnalytical thinkingProblem-solving, analysis and judgementResilienceVerbal & written communication and presentation skillsNegotiationStrategic agilityPlanningProject managementOrganisational awarenessExcellence and quality orientationEthical behaviourTechnical and professional knowledgeChange agentCoachingDecision makingDelegationOrganisingQuantitative analysisDepartmentsAdminRH Matjhabeng Private Hospital is an equal opportunity employer; external candidates will also be considered. Only shortlisted candidates will be contacted. Should you not receive any communication after 2 weeks of closing date, kindly consider your application as unsuccessful.Africa Health Care is an equal opportunity employer; external candidates will also be considered. Only shortlisted candidates will be contacted. Should you not receive any communication after 2 weeks of closing date, kindly consider your application as unsuccessful.
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