Hospital Case Manager & Clinical Coding Expert

Clinix Health Group (Pty) Ltd; Noordwes; On-site; ZAR 420,000 - 620,000; Full time

Job summary

Clinix Health Group (Pty) Ltd seeks an experienced hospital case manager to plan, coordinate and execute clinical coding at hospital level. You will use clinical knowledge to minimise financial risk and ensure accurate billing through comprehensive coding of patient care.

The role requires ICD-10 and CPT coding expertise, with 3–5 years’ hospital case management experience. Preferred qualification: Advanced coding certification; nursing degree is advantageous.

Qualifications

• Diploma/degree in Nursing is required.
• Advanced certification in Intermediate Coding is preferred.
• ICD-10/ CPT coding skills and understanding of diagnostic related groupers.

Responsibilities

• Plan, coordinate and execute Clinical coding in accordance with CHG standards.
• Ensure accurate, complete diagnostic and procedural coding of all patient records in hospital.
• Communicate with Funders (Medical Aids, COID, Government, RAF, DOL, etc.) regularly.
• Provide clinical information to Funders to update LOS, Level of Care, formulary use, devices and interventions as needed.
• Consult daily with health care providers regarding patient treatment.
• Maintain patient clinical status during hospitalization per funder requirements.
• Investigate funder, doctors, nurses and patient needs to deliver quality service.

Skills

Coding proficiency

Clinical knowledge

Funder coordination

Communication skills

Education

Diploma / Degree in Nursing

Advanced certification in Intermediate Coding

Degree in Nursing

Job description

Clinix Health Group (Pty) Ltd seeks an experienced hospital case manager to plan, coordinate and execute clinical coding at hospital level. You will use clinical knowledge to minimise financial risk and ensure accurate billing through comprehensive coding of patient care.

The role requires ICD-10 and CPT coding expertise, with 3–5 years’ hospital case management experience. Preferred qualification: Advanced coding certification; nursing degree is advantageous.