Case Manager

Department: Patient services and administration department

Location: Cintocare, Menlyn Maine, Pretoria

Closing date: 2 June 2023

Job Description

The incumbent will report to the patient services and administration manager and be responsible for liaising between patients and treating specialists and medical aids. The incumbent will have to apply their clinical knowledge and risk management regarding the length of stay, level of care and benefits available on medical funds.

The case manager will assist in leading and coaching the patient services team regarding the complete patient stay in the hospital to ensure fast and efficient submission of accounts to medical aids. Assist in reducing the risk by providing authorization as well as valuable updates of ICD/CPT codes.

Daily responsibilities will include but are not limited to:

Coding of patient accounts, submission of accounts, complete and accurate updates on discharge information, coding of private accounts, updating the length of stay, and obtaining letters of motivation requested by funders will be crucial functions
Application of clinical knowledge in patients’ risk management (financial and clinical) in terms of LOS, LOC, and medical benefits.
Any other duties assigned by the manager from time to time. E.g., assisting with short payments, LOM.
Daily communication and liaison with all role players, including the medical aids, treating specialists, nursing team, following up and escalating unresolved queries.
All tasks will be done following the relevant legislation, such as the POPI Act and all company policies and procedures.

Qualification

A degree / Diploma in Nursing is essential.
Intensive care experience and advanced coding experience is essential.
Intermediate and Advanced Clinical coding certificate from one of the registered institutions such as Africode is essential.

Experience

A minimum of 2 years of Clinical background(nursing) will be advantages and working experience as a case manager in a private healthcare facility with extensive knowledge of contractual obligations.

Skills and Attributes

Computer literate – experience working on Trimed will be an advantage.
Excellent general administrative skills.
Ability to plan, organize and control their work environment.
Ability to set objectives for themselves and achieve such goals in the given time frame.
Ability to make decisions and take responsibility for consequences.
Excellent interpersonal relationship skills (Liaising to patients/medical aids)
Sound knowledge of the ICD 10 and CPT coding.

Please send a comprehensive Curriculum Vitae and completed Application Form to careers@cintocare.com

If you have not heard from Cintocare Human Resource Department within one month of your application, please accept that your application was unsuccessful.

Cintocare will contact short-listed candidates only.

Cintocare is an equal opportunity employer.

For further information, contact Cintocare on (012) 945-3000.