Business Unit: The Fountain Private Hospital Posted: 2024-04-15, Closing: 2024-04-29 Description A vacancy exists for a Case Manager , reporting to the Patient Administration Manager . The position’s primary responsibilities include efficient patient case management and the delivery of an efficient and professional service to the internal and external customers. The successful candidate will be goal oriented with strong customer, quality, and performance focus. Critical Outputs Ensure that pre-admission and pre-authorization information is accurate and in accordance with hospital and funder procedures. Carry out clinical coding in accordance with CPT/CCSA and ICD requirements. Daily ward rounds for effective clinical update communication and timeous follow up with medical aids. Maintain patients’ clinical status in accordance with funder approval requirements for the duration of hospitalization; keeping patients informed and managing the entire hospital stays’ financial risk. Provide complete and accurate updates and discharge information of all accounts. Maintaining accurate accounts of all admissions Handle patient files in accordance with hospital procedures. Timeous electronic submission of accounts and follow up on short payments arising from case management related issues. Ensure the adherence of hospital staff to funder rules and coding procedures. Keep well informed on legislation pertaining to funders and related Health Care matters. Requirements Nursing: SANC registration RN or EN, with Case Management qualification/experience Nonclinical case managers with Case Management qualification/experience High school matric certificate. 3 – 5 years’ experience in clinical coding, private hospital case management and Medical Aid administration procedures. Knowledge of hospital billing, funder contracts and tariffs would be an advantage. Have sound computer literacy skills and working knowledge of MS office, word and excel. Excellent communication skills and the ability to form and build strong relationships &partnerships with internal&external stakeholders. Excellent negotiation skills&the ability to interact with tact and diplomacy. Collaboration/ Relationship Building Analytical thinking Problem-solving, analysis and judgement Resilience Verbal&written communication and presentation skills Negotiation Strategic agility Planning Project management Organisational awareness Excellence and quality orientation Ethical behaviour Technical and professional knowledge Change agent Coaching Decision making Organising Quantitative analysis Departments Admin The Fountain Private Hospital is an equal opportunity employer, external candidates will also be considered. Only shortlisted candidates will be contacted, should you not receive any communication after 2 weeks of closing date kindly consider your application as unsuccessful. Africa Health Care is an equal opportunity employer, external candidates will also be considered. Only shortlisted candidates will be contacted, should you not receive any communication after 2 weeks of closing date kindly consider your application as unsuccessful. #J-18808-Ljbffr