Job Description
Job Summary:
To deliver an effective case management process and facilitate the communication process between all role-players by providing accurate and timeous clinical information in order to minimize the financial risk for the company.
Minimum Qualifications and Experience:
- Grade 12.
- Registered Nurse, currently registered with SANC.
- Certificate in Coding (advantageous).
- 3 to 5 years’ experience in a private hospital or medical scheme environment in a Case management capacity.
- Working knowledge of ICD-10 and CPT codes.
- Computer proficiency – SAP System or similar.
Minimum Job Requirements:
- Ensure authorizations on admissions (daily) is accurate as per SAP system.
- Conduct daily case management rounds in allocated units to obtain updated clinical information from patient files. Comply with case management procedures, Medical Scheme contracts and legal aspe...