Case Manager (Re-advertised)

About the role

Herolim Private Hospital is looking for a Case Manager, reporting to the Patient Administration Manager, based in Mthatha, Eastern Cape. The post covers efficient patient case management and delivers a professional service to internal and external customers. It is a permanent position.

Key responsibilities

• Clinical coding in line with CPT and ICD requirements
• Ensure pre-admission and pre-authorisation information is accurate and follows hospital and funder procedures
• Maintain patients' clinical status during hospitalisation according to funder approval requirements, keeping patients informed and managing the financial risk of each stay
• Provide complete and accurate account updates and discharge information, and keep accurate admission accounts
• Handle patient files in line with hospital procedures
• Submit accounts electronically on time and follow up on short payments
• Ensure hospital staff follow funder rules and coding procedures
• Stay informed on legislation relating to funders and health care

Required profile

• SANC registration as an RN
• High school matric certificate
• 3-5 years of experience in basic finance and medical aid administration is an advantage
• Knowledge of hospital billing and tariffs is an advantage
• Excellent communication, negotiation and partnership-building skills

Required skills

• Sound computer literacy
• Working knowledge of MS Office, Word and Excel