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 le...