Case Manager
Red Ember Recruitment
KwaZulu, South Africa, Eastern Cape, ZA
1d ago

Case Manager

Main Purpose of the job

  • Check confirmations for L.O.S and L.O.C relative to each patient
  • Assess patient clinical reports for communication to Medical Aids
  • Process updates with Medical Aid for each patient
  • Intermediate / Advanced competency of ICD 10 and CPT coding
  • Check all ICD, CPT Coding and authorization numbers
  • Handle communication and queries with Medical Aid Case Managers
  • Assist Patients Doctors with patient requiring step down facilities
  • Liaising with Doctors, nursing staff and patients
  • Liaising with Debtors Department regarding any queries
  • Release and submit accounts timeously
  • Constantly monitoring patient status
  • Constantly liaising with Medical Aids updating patient’s status
  • Effective communication with patients, Doctors, Nursing staff, Medical Aids etc
  • Ensuring adequate record keeping
  • General administration duties
  • Education experience and competencies required

  • A valid Grade 12 or Matric equivalent Certificate
  • Previous case Manager experience required
  • Computer literacy essential
  • Nursing experience ICU & NNICU an added advantage
  • Strong Administration skills
  • Knowledge of Medical Aid Policies & Procedures
  • Above average interpersonal and Communication skills
  • Absolute compliance with Confidentiality Policies and Procedures
  • Maintaining standards
  • Adherence to Hospital Policy and Procedures
  • Ensuring adherence to all relevant statutes, statutory bodies rules and regulations, disciplinary codes and staff employee manuals.
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