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