Case Manager

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  • Published date: 2020/08/31
    • Johannesburg South, Johannesburg, Gauteng, South Africa

The incumbent will be responsible for the liaison between the patient and medical aid in order to secure payment for the hospital.
Duties and responsibilities:
•Liaise network of internal and external stakeholders to ensure that managed care of patients is maintained.
•Monitor and control costs for Managed Care Organisation patients.
•Confirm length of stay for all Managed Care Organisations patients.
•Managing quality checks on in hospital admission accounts as well as billed accounts to ensure that accounts are approved by the funders in full and paid within the agreed TAT.
•Assist with final authorization of Managed Care patient files.
•Ensure correct coding for all managed Care Organisation patients.
•Consult with the relevant service providers regarding the patients care treatment.
Requirements:
•Matric
•Registered Nursing Qualification
•3 years patient care experience
•Nursing policies and procedures
•Advanced Computer Literacy
•Preferably SAP experience
•Experience in handling of Case management short payments, as well as accounts rejections

Job details

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