Clinical Case Manager: ICD-10, Billing & Care Coordination

joint-medical-holdings; KwaZulu-Natal; On-site; ZAR 320,000 - 480,000; Full time

Job summary

Joint Medical Holdings is seeking a Case Manager to advocate for patients, optimize resources, and promote positive outcomes within a multidisciplinary hospital setting in KwaZulu-Natal.

You will ensure ICD-10/CCSA coding accuracy, manage billing processes, liaise with medical aids, doctors and patients, and contribute to timely case reviews while adhering to policy SLAs and Care Risk Management procedures.

Qualifications

• Must hold Nursing Qualification with registration with the SANC.
• Must be computer literate.
• Billing / Auditing experience will be advantageous.
• Experience in a multidisciplinary hospital environment.
• ICD-10 and CCSA coding experience is a requirement.
• Must have experience liaising with medical aids, doctors, and patients.

Responsibilities

• Adhering to policy and SLAs for clinical updates.
• Ensure precise ICD-10/CCSA coding.
• Meet month-end deadlines.
• Verify accurate and complete billing.
• Communicate with medical schemes.
• Manage DSO and optimize tools.
• Oversee rollout and adherence to Care Risk Management.
• Resolve rejections related to case management.
• Foster teamwork, communication and professional growth.
• Stay updated on industry trends and regulations.

Skills

ICD-10/CCSA coding

Computer literacy

Billing / Auditing experience

Education

Nursing qualification with Registration with the SANC

Job description

Joint Medical Holdings is seeking a Case Manager to advocate for patients, optimize resources, and promote positive outcomes within a multidisciplinary hospital setting in KwaZulu-Natal.

You will ensure ICD-10/CCSA coding accuracy, manage billing processes, liaise with medical aids, doctors and patients, and contribute to timely case reviews while adhering to policy SLAs and Care Risk Management procedures.