Business Unit: Royal Buffalo Specialist HospitalPosted: 2024-08-14, Closing: 2024-08-28Location: Eastern Cape, East LondonDescriptionA 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.RequirementsNursing: SANC registration RN or EN, with Case Management qualification/experience.Nonclinical case managers with Case Management qualification/experience.High school matric certificate.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.DepartmentsAdminRoyal Buffalo Specialist 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 the closing date, kindly consider your application as unsuccessful.
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