Case Manager

Edengph; Pietermaritzburg; On-site; ZAR 380,000 - 540,000; Full time

Job summary

Eden Gardens Private Hospital is seeking a Case Manager to oversee efficient patient case management and provide professional service to internal and external customers. The role reports to the Case Manager/Billings Supervisor and involves coordinating pre-admission data, coding, discharge information, and financial risk management throughout hospitalization.

Candidates should be a SANC-registered nurse with 2–3 years’ case management experience, familiarity with ICD-10/CPT-4, hospital billing,

Qualifications

• SANC registration as a nurse is mandatory.
• 2–3 years' experience as a case manager at hospital level or in medical schemes.
• Experience with medical aid administration (ICD10, CPT-4) and hospital billing.
• Knowledge of hospital tariffs and information systems.
• Ability to build strong internal and external stakeholder relationships.
• Computer proficiency.

Responsibilities

• Carry out clinical coding in line with CPT and ICD requirements.
• Verify pre-admission and pre-authorisation data per procedures.
• Maintain patient status and manage financial risk during hospitalization.
• Provide complete discharge information and update accounts.
• Maintain accurate admission records and handle patient files.
• Submit accounts electronically and follow up on short payments.
• Ensure staff adherence to funder rules and coding procedures.
• Stay informed on legislation affecting funders and healthcare matters.

Skills

Verbal communication

Written communication

Attention to detail

Problem solving

Teamwork

Education

SANC registration as a nurse

Tools

Hospital Information System

ICD10 / CPT coding

Job description

Case Manager

A Case Manager (General) vacancy exists at Eden Gardens Private Hospital, reporting to the Case Manager/Billings Supervisor. The successful candidates will be responsible efficient patient case management and the delivery of an efficient and professional service to the internal and external customers.

Key Responsibilities:

• Carry out clinical coding in accordance with CPT and ICD requirements.
• Ensure that pre-admission and pre-authorisation information is accurate and in accordance with hospital and funder procedures.
• Maintain patients’ clinical status in accordance with funder approval requirements for the duration of hospitalization; keeping patients informed and managing the entire hospital stays’ financial risk.
• Provide complete and accurate updates and discharge information of all accounts.
• Maintaining accurate accounts of all admissions.
• Handle patient files in accordance with hospital procedures.
• Timeous electronic submission of accounts and follow up on short payments arising from case management related issues.
• Ensure the adherence of hospital staff to funder rules and coding procedures.
• Keep well informed on legislation pertaining to funders and related Health Care matters.

Minimum Requirements:

• SANC registration as a nurse. 2-3 years’ experience as a case manager either at hospital level or with the Medical Schemes (preferably case management experience at hospital level)
• Experience with Medical Aid administration procedures (ICD10, CPT 4 Procedure Codes and Per Diems).
• Knowledge of hospital billing and tariffs and Hospital Information System will be advantageous.
• Ability to build good relations with various internal and external stakeholders.
• Computer proficiency.

Competencies

• Problem-solving, analysis and judgement
• Verbal and written communication
• Attention to detail
• Resilience
• Engaging diversity
• Professional and technical proficiency
• Adaptability
• Building relationships
• Customer responsiveness
• Organisational awareness
• Ethical behaviour
• Excellence orientation
• Critical thinking
• Planning and organizing
• Teamwork

Closing date : 20 October 2026

Eden Gardens Private Hospital welcomes applications from suitably qualified candidates for advertised positions and is committed to maintaining a professional working environment.

For more information about Eden Gardens Private Hospital and the healthcare services available in Pietermaritzburg, explore the rest of our website or contact us directly.