Case Manager
Posted on 2025-03-30
| Employer | Vencorp Placements (Pty) Ltd |
|---|---|
| Salary | 0 |
| Category | Medical |
| Location | Western Cape / Garden Route |
Job Summary
Responsibilities:
- Ensure all the relevant details on the hospital billing system are updated and accurate
- Plan, coordinate and execute clinical coding in accordance with relevant Client standards and protocols
- Ensure accurate, appropriate, and complete diagnostic and procedural coding of all patient records in the hospital
- Ensure correct and timeous finalization of cases to facilitate reimbursements from funders of claims
- Billing of patients with the day tariff and ward stock issued.
- Ensuring all billing checks are closed by the relevant function areas
- Ensure all the ward stock is billed, discharge the patient, and submit the claim.
- Supply all details regarding the patient’s history to Clinical partners
- Monitor and control costs for managed care organization patients
- Confirm length of stay for all managed care organizations’ patients
- Assist with final authorization of managed care patient files
- Ensure correct coding for all managed care organization patients
- Assist with the transfer of patients to other facilities
- Liaise network of internal and external stakeholders to ensure that managed care of patients is maintained
- Keep up to date with evolving policies and procedures
Requirements:
- Relevant Nursing Qualification or equivalent NQF level 6
- At least 3 years in the managed health care industry or private hospital
- Case Management in hospital and patient care experience
- Knowledge of ICD-10 & CPT coding, medical scheme rules
- Ability to liaise with external parties – clinicians and members.
- Computer literate – MS Office suite, i.e. Word, Excel.
Case Manager position available in Western Cape, Garden Route. This job position was posted by Vencorp Placements (Pty) Ltd. The job has been posted as a char8000 ad on 2025-03-30 at 01:29:27 in the Medical category
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