Impactful Billing Ops: Non-Clinical Case Manager

Netcare; Cape Town; On-site; ZAR 300,000 - 420,000; Full time

Job summary

Netcare is seeking a Non-Clinical Case Manager to mitigate financial risk by substantiating hospitalisation requirements and LOS/LOC through collaboration with clinical coders and funders. The role includes liaison with patients, clinicians and managed care organisations to provide accurate clinical motivation for stays.

Responsibilities include ensuring correct coding, data provision for LOS, and discharge planning while supporting billing KPIs within the team.

Qualifications

• DUXAH Non-clinical Case Manager qualification or equivalent.
• Experience or exposure to Case Management, ICD-10, CPT & CCSA.
• Computer literate and general administrative skills.

Responsibilities

• Manage case work to ensure LOS, LOC and medical aid benefits are correctly applied.
• Provide electronic data to support length of stay and level of care.
• Ensure accurate clinical coding and classification on the system.
• Liaise with patients, clinicians and funders to support billing.
• Escalate case management trends to the Billing Manager for funder meetings.
• Support discharge planning and bed movements as needed.

Skills

Customer focus

Personal work ethic

Building relationships

Communication

Teamwork

Technical knowledge

Education

DUXAH Non-clinical Case Manager qualification

Job description

Netcare is seeking a Non-Clinical Case Manager to mitigate financial risk by substantiating hospitalisation requirements and LOS/LOC through collaboration with clinical coders and funders. The role includes liaison with patients, clinicians and managed care organisations to provide accurate clinical motivation for stays.

Responsibilities include ensuring correct coding, data provision for LOS, and discharge planning while supporting billing KPIs within the team.