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Website Mediclinic
Job Description:
To coordinate the hospital case management process and facilitate the communication process between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation.
Job Responsibilities:
- Consistently and timeously communicate with Funders as contractually agreed through the relevant case management channels
- Ensure compliance to case management procedures, contracts and legal aspects by utilising available resources and systems
- Lead and manage the people in the Case Management team (if applicable)
- Ensure correct and timeous finalisation of cases to facilitate reimbursements from funders of claims
- Ensure clinical coding standards are adhered to as per Level 3 coding guideline
- Minimise financial risk by effectively managing patient stay
Job Requirements:
- Daily workflow; managing deviances; coding; and case management processes
- Scientific nursing principles and process
- Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.)
- Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.)
- Funder Contracts; Medical aid requirements/narrations
- Application of clinical codes and finalisation thereof (Level 3 coding)
- B2B EMS (electronic message system: check status of authorisations and use for trouble,shooting)
- Computer literate (Microsoft Office)
- Authorisation and motivation of Level of Care; Length of Stay; Short Payments etc.
- Anatomy; physiology and terminology
Job Details:
Company: Mediclinic
Vacancy Type: Full Time
Job Location: Pietermaritzburg, KwaZulu-Natal, SA
Application Deadline: N/A
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