Case Manager

4 weeks ago


Pietermaritzburg, KwaZulu-Natal, South Africa Immploy Recruitment Agency CC Full time
Job Title: Case Manager

We are seeking a highly skilled and experienced Case Manager to join our team at Immploy Recruitment Agency CC. As a Case Manager, you will play a critical role in ensuring the efficient management of patient cases and the delivery of high-quality services to our internal and external customers.

Key Responsibilities:
  • Clinical Coding: You will be responsible for carrying out clinical coding in accordance with CPT and ICD requirements, ensuring accuracy and compliance.
  • Pre-Admission and Pre-Authorisation: You will ensure that pre-admission and pre-authorisation information is accurate and in accordance with hospital and funder procedures.
  • Patient Management: You will maintain patients' clinical status in accordance with funder approval requirements, keeping patients informed and managing the entire hospital stay's financial risk.
  • Account Management: You will provide complete and accurate updates and discharge information of all accounts, maintaining accurate accounts of all admissions.
  • File Management: You will handle patient files in accordance with hospital procedures, ensuring timely electronic submission of accounts and follow-up on short payments arising from case management-related issues.
  • Compliance: You will ensure the adherence of hospital staff to funder rules and coding procedures, keeping well-informed on legislation pertaining to funders and related healthcare matters.
Minimum Requirements:
  • Qualifications: SANC registration as a Registered Nurse or an Enrolled Nurse.
  • Experience: 5 years' experience as a case manager either at hospital level or with the Medical Schemes (preferably case management experience at hospital level).
  • Skills: Experience with Medical Aid administration procedures (ICD10, CPT 4 Procedure Codes and Per Diems), knowledge of hospital billing and tariffs, and Hospital Information System will be advantageous.
  • Interpersonal Skills: Ability to build good relations with various internal and external stakeholders.

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