Case Manager

4 weeks ago


City of Johannesburg Metropolitan Municipality, South Africa Clinix Health Group Ltd Full time
Job title : Case ManagerJob Location : Gauteng, SowetoDeadline : March 06, 2025Quick Recommended Links
  • Jobs by Location
  • Job by industries

Job Summary:

  • To plan, coordinate and execute case management work at hospital level. The incumbent utilises clinical knowledge to minimise financial risk and ensure accurate billing through comprehensive accurate coding of patient care.

Minimum Qualifications and Experience:

  • Nursing Diploma
  • Registered Nurse
  • ICD Code & CPT Coding knowledge
  • 3-5 years’ experience as a hospital case manager

Minimum Job Requirements:

  • Liaise with Receptionist for authorizations.
  • Ensure compliance to case management procedures, standards and protocols.
  • Plan, coordinate and execute Clinical coding in accordance with relevant CHG standards and protocols.
  • Ensure accurate, appropriate and complete diagnostic and procedural coding of all patient records in the hospital.
  • Timeously and consistently communicate and follow up with Funders (Medical Aids, COID, Government, RAF, DOL, etc.)
  • Provide appropriate clinical information to Funders in order to update Length of Stay, Level of Care, formulary utilization, assistive devices / Prosthesis, diagnostic interventions, therapy intervention and procedural interventions and required change in the facility.
  • Consult daily with all relevant health care providers with regards to patient treatment
  • Ensure the maintenance of patients’ clinical status (subsequent interventions and treatments) in accordance to Funder requirements for the duration of hospitalization
  • Ensure the correct categorization and management of different patient accounts to facilitate reimbursement by Funders.
  • Ensure accurate and timeous finalization of cases to facilitate reimbursement by Funders.
  • Minimize financial risk by the effective management of patient hospitalization.
  • Follow the established and approved escalation processes in the event of a decline of payment by Funders.
  • Ensure to remain in the group and facility targets of 3 days for WIP (work in progress) and DNYB (discharged not yet billed).

  • Medical / Healthcare  jobs

  • Case Manager

    6 days ago


    Century City, South Africa Renting 2 Buy Full time

    At R2B Group, we would be nothing without the success of our clients and our teams. We are seeking high calibre, self motivated individuals to help us make people’s dreams of home ownership come alive. As a leading property and finance group that has been helping hundreds of every day Australians get their foot into the property market with little to no...

  • Case Manager

    5 days ago


    Johannesburg, South Africa Mass Staffing Projects Full time

    **Job Information** - Location- Johannesburg- Salary- R400k-R300k- Job Type- Permanent- Education- Degree/Diploma in Nursing- Experience- +2 years’ experience in case management- - pharmacy.jobs(at)staffingprojects.co.za- Fax- 0866023398This just in! A vacancy for a case manager at a private hospital in Johannesburg is currently...

  • Case Manager

    1 week ago


    Johannesburg, South Africa BQuad Solutions Full time

    Manage calls from Hospital Case Managers regarding authorisations for procedures in hospital, **trauma, casualty**, GP or dental rooms - Case management from issuing a guarantee of payment to final discharge and follow up treatment - Manage clinical risk to decrease claims over utilisation - Pre-authorisation of GP visits per benefit option rules - Classify...

  • Case Manager

    2 weeks ago


    Johannesburg, South Africa LetsLink Pty Ltd Full time

    Role Title: Case Manager Role Summary: Are you a healthcare professional looking to make a significant impact in patient care and financial risk management? If so, we have an exciting opportunity for you to join the team of a private hospital based in Gauteng as a Case Manager. In this role, you will leverage your clinical knowledge and expertise to ensure...

  • Case Manager

    3 days ago


    Johannesburg, South Africa Clinix Health Group (Pty) Ltd Full time

    **Job Summary**: To plan, coordinate and execute case management work at hospital level. The incumbent utilities clinical knowledge to minimise financial risk and ensure accurate billing through comprehensive accurate coding of patient care. **Minimum Qualifications and Experience*** - Nursing degree / diploma. - Current registration with South African...

  • Case Manager

    2 days ago


    Johannesburg, South Africa SD Consult Full time

    **Role Summary** The Case Manager utilizing clinical knowledge and expertise, mitigates financial risk through comprehensive and accurate coding of hospital events, communication with funders on justification for hospitalization level of care and length of stay. **Key Word Output and Accountabilities**: - Monitor and action risk related to medical aid...

  • Case Manager

    3 days ago


    Johannesburg, South Africa Mass Staffing Projects Full time

    **Requirements**: - Degree/Diploma in Nursing - Minimum 4 years nursing experience in a multidisciplinary hospital environment - Intensive Care nursing experience is an advantage - Hospital or Medical Scheme Case Management an advantage - Experience in ICD 10 and CPT 4 coding an advantage


  • Johannesburg, Gauteng, South Africa Mibco Full time

    Job DescriptionWe are seeking a highly organized and detail-oriented Case Management Officer to join our team at Mibco.The successful candidate will be responsible for monitoring and accounting for stationery and consumable levels, attending to professional drafted correspondence, and generating case management reports when requested.Duties and...

  • Case Management Lead

    2 weeks ago


    Johannesburg, South Africa Complement Recruitment Full time

    Complement Recruitment are recruiting for a Case Management Lead for a permanent position based in Sandton, Johannesburg, Gauteng. Our client is looking for an experienced, commercially minded and operationally strong case management lead with a proven track record of implementing and streamlining projects and making sure they have high impact for the...


  • Johannesburg, South Africa Motor Industry Bargaining Council Full time

    **Duties & Responsibilities** - Monitor and account for stationery, consumable levels - Attend to professional drafted correspondence, serving and courier documents - Generate case management Reports when requested - Assist at reception(front office) or other Case Manager’ when required, - Book venues, Interpreters and Panelist for cases with proper notice...


  • Johannesburg, South Africa MHR Full time

    **Job Advert Summary**: Are you in the market for temporary case manager opportunities at a well-known and dynamic agency? MHR is urgently looking for experienced **Hospital Case Managers** to work **part-time shifts** at a private hospital in **Sandton area** in **Johannesburg**. **Minimum Requirements**: **Requirements**: - Professional Nurse with at...


  • Johannesburg, Gauteng, South Africa Mibco Full time

    Join to apply for the Case Management Officer role at Motor Industry Bargaining Council.Get AI-powered advice on this job and more exclusive features.Duties & ResponsibilitiesMonitor and account for stationery, consumable levelsAttend to professional drafted correspondence, posting, serving and courier documentsGenerate case management Reports when...


  • Johannesburg, South Africa Vencorp Placements Full time

    **Requirements**: - Degree or Diploma in General Nursing Science or Enrolled Nurse - Valid SANC registration - At least three years’ proven experience in case management and clinical coding - Knowledge of hospital patient services and case management processes - Knowledge and understanding of CPT & ICD coding - Knowledge of Funder contracts, scheme rules,...


  • Johannesburg, South Africa AristoSourcing Inc. Full time

    AristoSourcing LLC is an Outsourcing company highly focused on the Digital Marketing Industry. Our company has been in the industry for more than 7 years. We hired and referred skilled and experienced Virtual Assistants to work and collaborate directly with our respective clients from different parts of the globe that offer 100% remote work for talented and...


  • Johannesburg, South Africa De Beers Group of Companies Full time

    **Company Description - Join us as a Case Management Specialist** People are at the heart of our business and HR in Anglo American seeks to provide the Group with a capable and engaged workforce within a culture that fosters safety, inclusion, innovation and performance. In this we will create a sustainable competitive advantage for our organisation. We're...


  • Johannesburg, Gauteng, South Africa Fusion Personnel Full time

    Requirements:Nursing qualification (Registered or Enrolled Nurse).3 to 5 years of nursing experience, with back-office or case management experience preferred.Knowledge of medical scheme regulations, ICD-10 coding, tariffs, and case management protocols.Strong attention to detail, communication, and administrative skills.Computer literacy, including...

  • Case Manager

    2 days ago


    Johannesburg, South Africa Medical Protection Society Full time

    Job Introduction The Member Cases and Claims Division is at the forefront of protecting the careers, reputation and financial risk of our members worldwide. The purpose of the role is to support the provision of excellent case handling services for members which is trusted and valued and provides fair treatment and outcomes. The role will do this by managing...


  • Johannesburg, South Africa Mass Staffing Projects Full time

    **Job Information** - Location- Johannesburg- Salary- R500k-R400k- Job Type- Permanent- Education- Degree/Diploma in Nursing- Experience- +3 years case management experience- - pharmacy.jobs(at)staffingprojects.co.za- Fax- 0866023398Are you looking for a career growth? Then this is for you! A vacancy for a Quality Control Case Manager at a private hospital...


  • City of Johannesburg Metropolitan Municipality, South Africa Clinix Health Group Ltd Full time

    Job title : Patient Services ManagerJob Location : Gauteng, JohannesburgDeadline : March 17, 2025Quick Recommended Links Jobs by Location Job by industries Job summary: To plan, organize and execute the revenue cycle management at a hospital facility. The incumbent manages a team of specialist that contribute to hospital finances through accurate billing...


  • Johannesburg, South Africa Kaelo Full time

    Company Description Kaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change. Kaelo meets the Healthcare needs of Corporate and Retail clients across South Africa - products offerings include Medical Insurance, Medical Aid, Gap Insurance, Kaelo Money and employee...