Case Manager – Kimberley, Northern Cape
Employeur non precise · Kimberley
Job description
About the role
The Case Manager uses clinical knowledge to mitigate financial risk by accurately coding hospital events, justifying levels of care and length of stay, and communicating with medical aid funders.
Key responsibilities
- Apply clinical expertise to justify patient hospitalisation, treatment, length of stay and level of care.
- Monitor and act on risks related to medical aid benefits and hospitalisation.
- Ensure accurate, specific and comprehensive clinical coding.
- Communicate timely and effectively with medical aids and follow up on authorisations.
- Review authorisation aspects, mitigate financial risk and release cases for billing.
- Liaise with internal and external stakeholders regarding patient treatment.
- Adhere to NHN Managed Health Care rules of engagement and comply with relevant legislation.
Required profile
- B Degree Nursing Qualification or equivalent NQF level 6.
- 1–2 years experience in an administrative role or auditing.
- Advanced computer literacy.
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Employeur non precise
Kimberley