Brief Description

Main Purpose of the job • Check confirmations for L.O.S and L.O.C relative to each patient • Assess patient clinical reports for communication to Medical Aids • Process updates with Medical Aid for each patient • Intermediate / Advanced competency of ICD 10 and CPT coding • Check all ICD, CPT Coding and authorization numbers • Handle communication and queries with Medical Aid Case Managers • Assist Patients Doctors with patient requiring step down facilities • Liaising with Doctors, nursing staff and patients • Liaising with Debtors Department regarding any queries • Release and submit accounts timeously • Constantly monitoring patient status • Constantly liaising with Medical Aids updating patient’s status • Effective communication with patients, Doctors, Nursing staff, Medical Aids etc • Ensuring adequate record keeping • General administration duties Education Experience And Competencies Required • A valid Grade 12 or Matric equivalent Certificate • Previous case Manager experience required • Computer literacy essential • Nursing experience ICU & NNICU an added advantage • Strong Administration skills • Knowledge of Medical Aid Policies & Procedures • Above average interpersonal and Communication skills • Absolute compliance with Confidentiality Policies and Procedures • Maintaining standards • Adherence to Hospital Policy and Procedures • Ensuring adherence to all relevant statutes, statutory bodies rules and regulations, disciplinary codes and staff employee manuals