Case Manager

Joint Medical Holdings; KwaZulu-Natal; On-site; ZAR 200 000 - 300 000; Full time

Job summary

A healthcare organization in KwaZulu-Natal is seeking a Registered Nurse to manage clinical risk and ensure accurate coding and billing. The ideal candidate will have experience in a multidisciplinary environment, especially with ICD 10 and billing processes. This role offers a competitive salary, including benefits such as a 13th cheque and study assistance.

Benefits

13th Cheque

Medical Aid

Pension Fund

Study Assistance

Qualifications

• Registration with the SANC as a Registered Nurse.
• Must have Billing/Auditing experience essential.
• Experience in a multidisciplinary hospital environment.

Responsibilities

• Manage risk through application of clinical knowledge and service level agreements.
• Ensure accurate and complete billing.
• Ensure compliance with Care Risk Management Procedures.

Skills

ICD 10 coding

Billing experience

Computer literacy

Liaising with medical aids

Education

Registered Nurse (RN)

Job description

Overview

PURPOSE OF POSITION

The incumbent will be responsible for managing risk through application of clinical knowledge, best operating procedures, service level agreements and accurate coding. EQUITY REQUIREMENTS Preference will be given to African males or females.

Key Responsibilities

• Following the JMH policy with regards to clinical updating within turnaround times and service level agreements.
• Accurate and complete ICD 10 / CCSA coding.
• Month end deadlines.
• Ensure accurate and complete billing.
• Ensure adequate and appropriate information is communicated about the medical schemes.
• To manage the internal DSO and ensure optimization of tools used.
• Ensure complete rollout and compliance of Care Risk Management Procedures and Protocols.
• Ensure effective resolution to rejections relating to case management.

Competencies

The following will be advantageous

Minimum Requirements

• Educational Qualifications & Experience
• Registration with the SANC as a RN.
• Must be computer literate.
• Must have Billing / Auditing experience essential.
• Experience in a multidisciplinary hospital environment.
• ICD 10 and CCSA coding experience is required.
• Must have experience in liaising with medical aids, doctors and patients.
• Competitive Basic
• 13th Chq-Med Aid-Pension Fund and Study Assistance