Applications are invited from suitably qualified individuals who meet the job requirements as set out below. JOB TITLE: CASE MANAGER REPORTING TO: Patient Administration Manager SERVICE GROUP/UNIT: Finance Key Responsibilities: · Patient Case Management · Responsible for the case management process within the hospital. · Interacts with medical schemes to ensure that authorizations are provided timeously. · ICD 10 and CPT clinical coding as per policies of specialized wards criteria. · Provides support for the management of alternative fee structures. · Liaison with doctors on funder requirement when necessary. · Continuous performance and quality management · Interpretation and implementation of Scheme benefit rules. · Optimizing of billing processes. · Audit patient files for accurate accounts submission. · Account release as per NHN billing guidelines, medical aid rules and contracted agreements. · Daily report utilization and management. Communication: · Liaise with Doctors regarding patient progress. · Liaise with nurses in the wards and pharmacy staff. · Liaise with Case Managers of managed care organization regarding pre-Authorizations, length of stay, level of care and other additional cases. Minimum Qualifications&Experience: · Matric/Grade 12 Certificate. · Registered with South African Nursing Council as an Enrolled Nurse or Professional Nurse will be a recommendation. · Must have ICD10 coding and CPT coding qualification. · Must have at least 2 years of relevant work experience in private healthcare environment. · Knowledge and experience with account billing and ARM agreements. · Proven Computer Literacy Skills (MS Office Package) · Knowledge and Experience in administering medical and managed care processes. · Good interpersonal and communication skills. Application criteria: Applications can be submitted to the HR office or via email at: hr@kiaathospital.com / recruitment@kiaathospital.com. For Hand Deliveries: 1 Kiaat Ridge Boulevard Required documents: Application letter, CV, recently certified copies of academic certificates, ID and valid SANC certificate (if applicable). No late applications will be accepted. Closing date: Friday, 19 April 2024 Time: 16h00 Enquiries: Please direct all your enquiries to Charles Shiba, Human Resources Manager at 013492 0390. #J-18808-Ljbffr