Mediclinic Worcester Vacancies – Hospital Case Manager

Job Description:

Job Responsibilities:

• Minimise financial risk by effectively managing patient stay
• Lead and manage the people in the Case Management team (if applicable)
• Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems
• Ensure clinical coding standards are adhered to as per Level 3 coding guideline
• Ensure correct and timeous finalisation of cases to facilitate reimbursements from funders of claims
• Consistently and timeously communicate with Funders as contractually agreed through the relevant case management channels

Job Requirements:

• Application of clinical codes and finalisation thereof (Level 3 coding)
• B2B EMS (electronic message system: check status of authorisations and use for trouble,shooting)
• Authorisation and motivation of Level of Care; Length of Stay; Short Payments etc.
• Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.)
• Funder Contracts; Medical aid requirements/narrations
• Daily workflow; managing deviances; coding; and case management processes
• Computer literate (Microsoft Office)
• Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.)
• Patient admin programmes on the AS400 system
• Scientific nursing principles and process
• Anatomy; physiology and terminology

Qualification & Experience:

Job Details:

Company: Mediclinic

Vacancy Type:  Full Time

Job Location: Cape Town, Western Cape, South Africa

Application Deadline: N/A

Apply Here

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