Case Manager

Full Time _Gauteng_, _Randfontein_ April 22, 2024 - May 22, 2024 Manager - Medical & Optometry

**Job Overview**:
**Requirements**:

- B degree/diploma nursing qualification and/or Case Management qualification
- Diverse clinical nursing experience
- Case Management experience
- ICD-10 / CPT coding qualification or experience
- SAP IS-H experience
- Proficiency in Microsoft Office

**Duties & Responsibilities**:

- Monitor and action risk related to medical aid benefits and hospitalisation
- Ensure accurate, specific and comprehensive clinical coding
- Timeous, effective communication and follow-up with medical aids
- Review authorisation aspects approved, mitigating financial risk and final releasing the case for billing
- Liaise with a network of internal and external stakeholders regarding patient treatment
- Adhere to NHN Managed Health Care rules of engagement
- Compliance with all industry legislative acts, regulations and circulars