The incumbent will be responsible for liaising between the patients, treating clinicians, and medical aids in order to provide an accurate and true account of the patient’s stay in 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
- Accurate and timeous communication and follow up with medical aids
- Effective communication with other role players in the healthcare team
- Provide appropriate clinical information to Medical Aids
- Effective and timeous communication with the member of the fund when appropriate
- Coding of patient accounts
- Application of clinical knowledge for effective ICD 10 and CPT 4 coding of patient records
- Code all Managed Care Organization patients’ records with ICD 10 and CPT4 codes
- Code all Private patient records
- Code all WCA/COID patient records
- Utilize all available resources for accurate and appropriate coding
- CPT coding and an understanding of coding standards
- ICD 10 coding and an understanding of coding standards.
- Multi-disciplinary clinical experience and knowledge of medical terminology.
- Excellent communication skills.
- Attention to detail.
- Ability to work extended hours.
Qualification & Experience:
- Relevant Nursing qualification
- Certificate in ICD-10
- SANC registration as a Registered or Enrolled Nurse
- Min of 3 years’ experience in Case management in a hospital environment
- Intermediate computer proficiency.
- Intensive Care Nursing experience is beneficial
- Hospital or Medical Scheme Case Management an advantage
- Previous hospital and medical scheme case management experience is beneficial
- Experience in ICD 10 and CPT 4 coding
- General administrative skills
Vacancy Type: Full Time
Job Location: Johannesburg, SA
Application Deadline: N/A