Vacancieshut
Website Lenmed
Job Description:
The Case Manager utilising clinical knowledge and expertise, mitigates financial risk through comprehensive and accurate coding of hospital events, communication with funders on justification for hospitalisation level of care and length of stay.
Job Responsibilities:
- Compliance with all industry relevant legislative acts, regulations and circulars
- Monitor and action risk related to medical aid benefits and hospitalisation.
- Timeous, effective communication and follow up with medical aids.
- Responsible for application of clinical knowledge in justifying patient hospitalisation in terms of treatment, length of stay and level of care.
- Liaise with a network of internal and external stakeholders regarding patient treatment.
- Review authorisation aspects approved, mitigating financial risk and final releasing the case for billing.
- Adhere to the NHN Managed Health Care rules of engagement.
Qualification & Experience:
- Diverse clinical nursing experience
- ICD-10 / CPT Coding Qualification or Experience
- SAP IS-H experience advantageous
- Case Management experience
- Proficiency in Microsoft Office products
- B Degree/Diploma Nursing qualification and/or Case Management qualification
Job Details:
Company: Lenmed
Vacancy Type: Full Time
Job Location: Kimberley, Northern Cape, SA
Application Deadline: N/A
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