Description:
Key Performance Areas:
- Responsible for application of clinical knowledge in justifying patient hospitalisation in terms of treatment, length of stay and level of care.
- Monitor and action risk related to medical aid benefits and hospitalisation.
- Ensure accurate, specific and comprehensive clinical coding
- Timeous, effective communication and follow up with medical aids.
- Review authorisation aspects approved, mitigating financial risk and final releasing the case for billing.
- Liaise with a network of internal and external stakeholders regarding patient treatment.
- Adhere to the NHN Managed Health Care rules of engagement.
- Compliance with all industry relevant legislative acts, regulations and circulars
Post Requirements:
- B Degree/Diploma Nursing qualification and/or Case Management qualification
- Diverse clinical nursing experience
- Case Management experience
- ICD-10 / CPT Coding Qualification or Experience
- SAP IS-H experience advantageous
- Proficiency in Microsoft Office products
07 Jan 2026;
from:
gumtree.co.za