RPO Recruitment's client is looking for a Case Manager to join their team in Mitchells Plain, Cape Town.
The successful candidate will be responsible for managing and improving patient billing outcomes, coding, and coordinating medical aid-related processes within a healthcare facility.
Responsibilities:
Assess patient conditions and develop appropriate care plans
Communicate with patients and medical aid schemes
Resolve queries from patients and medical aid schemes
Ensure timely and accurate updates of patient information
Perform CPT and ICD coding
Obtain doctors' letters, motivations, and justifications for managed care cases
Monitor patient admissions and identify restrictions placed by medical aid structures
Maintain a systematic monitoring control system for managed care patients
Handle patient queries
Update hospital records and information systems
Requirements:
Qualified Registered Nurse or Enrolled Nurse with relevant experience, registered with SANC
Minimum 3 years of nursing experience in a multidisciplinary hospital environment
Knowledge and experience in ICD-10 and CPT coding
Experience in case management within a hospital or medical aid environment
Knowledge of Prescribed Minimum Benefits (PMB) and scheme policies
Strong communication, analytical, and computer skills (MS Office, hospital systems)
Benefits
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