Healthcare Case Administrator - Billing & Authorizations

Joint Medical Holdings; Durban; On-site; ZAR 180,000 - 240,000; Full time

Job summary

Joint Medical Holdings in Durban, South Africa seeks a Case Administrator to provide administrative and financial support to the Case Management function from admission to discharge and account submission.

You will ensure medical-aid information, authorisations and documentation are followed up promptly, contribute to accurate billing, reduce claim rejections, improve cash flow and debtor management.

Qualifications

• Grade 12 / Matric.
• Experience in a private hospital, medical‑aid, healthcare administration, billing or case‑management environment.
• Knowledge of medical‑aid processes and hospital patient administration.
• Understanding of authorisations, medical‑aid benefits and funding requirements.
• Basic understanding of hospital billing and account submission processes.
• Computer literacy, including Microsoft Office.
• Experience with hospital information systems would be advantageous.

Responsibilities

• Obtain and verify medical-aid membership, benefits and required pre-authorizations.
• Follow up outstanding authorizations, extensions and funding requirements.
• Assist with daily patient-in-progress reporting and ensure required documentation is obtained.
• Follow up outstanding clinical and administrative information required for account finalization.
• Ensure patient accounts are complete and identify information that may result in claim rejection or payment delays.
• Liaise with Billing, Bill Audit and Case Management regarding outstanding account requirements and billing queries.
• Monitor medical-aid claim rejections and queries and obtain information required for resolution.
• Monitor patients who remain in hospital, including long‑stay and high‑value cases, and ensure funding information is current.
• Maintain accurate case‑management records and reports and ensure information is captured timeously.
• Adhere to hospital policies, medical‑scheme requirements, confidentiality standards and agreed turnaround times.

Skills

Healthcare administration

Billing

Case management

Microsoft Office

Hospital information systems

Education

Grade 12 / Matric

Tools

Microsoft Office

Hospital information systems

Job description

Joint Medical Holdings in Durban, South Africa seeks a Case Administrator to provide administrative and financial support to the Case Management function from admission to discharge and account submission.

You will ensure medical-aid information, authorisations and documentation are followed up promptly, contribute to accurate billing, reduce claim rejections, improve cash flow and debtor management.