Job Description: The Group is focused on providing specialist-orientated, multidisciplinary services across the continuum of care in such a way that the Group will be regarded as the most respected and trusted provider of healthcare services by patients, medical practitioners, funders and regulators of healthcare in each of its markets. Job Responsibilities: 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 Consistently and timeously communicate with Funders as contractually agreed through the relevant case management channels Ensure correct and timeous finalisation of cases to facilitate reimbursements from funders of claims Minimise financial risk by effectively managing patient stay Lead and manage the people in the Case Management team (if applicable) Job Requirements: Scientific nursing principles and process Anatomy; physiology and terminology Funder Contracts; Medical aid requirements/narrations Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.) Computer literate (Microsoft Office) Authorisation and motivation of Level of Care; Length of Stay; Short Payments etc. Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.) B2B EMS (electronic message system: check status of authorisations and use for trouble,shooting) Qualification & Experience: N: Clinical qualification Minimum of 3 years in a clinical role Registered Nurse / Professional Nurse or qualified Paramedic Job Details: Company: Mediclinic Vacancy Type: Full Time Job Location: Durbanville, Western Cape, SA Application Deadline: N/A Apply Here Vacancieshut.com
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