Netcare Vacancies Near me – Case Manager

Job Description:

The incumbent will be responsible for liaising between the patients and medical aids in order to secure payment for the hospital. The Case Manager will also assume responsibility for the application of clinical knowledge in the risk management of patients in terms of length of stay, level of care and medical aid benefits available.

Job Responsibilities:

• Assessing of the patients accounts to ensure accurate billing as per Netcare Billing Manual in conjunction with the
• Netcare scale of benefits as well as the specific Alternative Re-imbursement contract interpretation document.
• Following the Netcare Case Managers Policy with regards to updating clinical information, and communication with the medical schemes.
• Accurate and complete ICD 10 and CPT coding.
• Complying with the South African Coding standards with regards to ICD 10 Coding.
• Decrease coding errors which impact negatively on the Alternative Reimbursement Contracts.
• Month end deadlines.
• Ensure proper records are kept of each and every patient intervention and communication with their appointed agent or medical aid.
• Ensure that adequate and appropriate information is communicated to the medical funds, where more is requested, that an appropriate indemnity is placed on record to protect the rights of Netcare.
• Ensure that at all times the knowledge of the medical schemes legislation, coding requirements and related acts remain current.
• Ensure accurate and complete billing.
• Complying with contractual turn around times.
• Assisting with data capturing when necessary

Job Requirements:

• Nursing policies and procedures

Qualification & Experience:

• Registration with the South African Nursing Council as a Registered Nurse/EN
• Minimum 3 years experience in a multidisciplinary hospital environment
• Computer literacy is essential
• 1-2 years recent or current experience as a Case Manager
• People currently in a position of Case Management is preferred
• ICD-10 and CPT coding experience is required
• Minimum 3 years experience in a multidisciplinary hospital environment
• Intensive Care Nursing experience is beneficial
• Previous hospital and medical scheme case management experience is beneficial
• General administrative skills
• Computer literacy

Job Details:

Company: Netcare

Vacancy Type:  Full Time

Job Location: Die Hoewes, Centurion, SA

Application Deadline: N/A

Apply Here

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