Case Manager – Part Time (Hospital Group) – Berea, Kwa-Zulu Natal 111 views
Job Overview
Requirements:
- B degree/diploma nursing qualification and/or Case Management qualification
- Diverse clinical nursing experience
- Case Management experience
- ICD- / CPT coding qualification or experience
- SAP IS-H experience
- Proficiency in Microsoft Office
Duties & Responsibilities:
- Responsible for application of clinical knowledge in justifying patient hospitalisation in terms of treatment, length of stay and level of care
- 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
