Key Responsibilities: Accurately manage pre-admission and pre-authorisation processes in line with hospital and funder protocols Perform clinical coding in accordance with CPT/CCSA and ICD standards Conduct daily ward rounds for clinical updates and coordinate with medical aids for timely authorization Monitor and maintain patient clinical status updates to align with funder requirements throughout hospitalization Manage financial risk by ensuring patients are informed and accounts are accurate throughout the hospital stay Ensure proper electronic submission of accounts and follow up on short payments related to case management Maintain clear and compliant patient admission records and discharge information Promote compliance with funder regulations and hospital coding procedures Keep up-to-date with relevant healthcare legislation, funder rules , and administrative protocols Build and maintain effective relationships with internal and external stakeholders Minimum Requirements: Registered Nurse (RN) or Enrolled Nurse (EN) with SANC registration and Case Management experience/qualification OR Non-clinical professionals with a Case Management qualification and experience Matric certificate 35 years experience in private hospital case management, clinical coding, and medical aid processes Solid understanding of hospital billing, funder contracts, and medical tariffs is advantageous Proficient in Microsoft Office (Word, Excel) and general computer systems Excellent negotiation, communication, and stakeholder engagement skills Ability to work with tact, diplomacy, and a strong customer service focus Core Competencies: Strong interpersonal and relationship-building skills Analytical thinking and sound judgment Resilience and adaptability Effective verbal and written communication Cultural awareness and diversity engagement High ethical standards and integrity Organisational awareness and service excellence Ability to influence and negotiate effectively

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