Case Manager Specialist

Patient Services
Life Wilgers Hospital
Case Manager Specialist

A vacancy exists for a Case Manager Specialist, based at Life Wilgers Hospital, reporting to the Patient Services Manager. The successful candidate will be responsible for managing the financial and clinical risks of the patient event by ensuring accurate coding, clinical updates and accounts submissions of patient hospitalisation to achieve key strategic objectives.

Critical Outputs
  • Maximisation of correct revenue
  • Drive and ensure correct application and correct interpretation of RSRT's, accuracy of coding and compliance to Company policies regarding authorisations.
  • Manage and monitor input on Impilo, manage re authorisations, rejections and delays, monitor insurance verification, submission of accurate accounts to Funders and adhoc reports.
  • Ensure timeous update of patient events as per Life Healthcare policies and protocols.
  • Adhere to ISO 9001 standards and patient escalation processes.
  • Ensure compliance of SLA’s with internal stakeholders, foster positive professional relationships.
  • Ensure compliance in terms of the RSRT framework.
  • Effective communication pertaining to patient queries, submission of motivation letters required and short payments.
  • A registered nurse with a qualification or experience in Intensive Nursing Science
  • Clinical Coding experience of at least one year and / qualification in clinical coding (ICD 10 and CPT coding).
  • Case management experience.
  • Knowledge of Impilo and or IMEDS would be advantageous.
  • Knowledge of funder contracts, rules, copayments and exclusions would be advantageous.
  • Computer proficiency in MS Office.
  • Problem-solving, analysis and judgement
  • Resilience
  • Engaging diversity
  • Influencing
  • Drive & energy
  • Excellence orientation
  • Ethical behaviour
  • Building relationships
  • Customer responsiveness
  • Organisational awareness
Closing date
Thursday, May 19, 2022

Internal applicants - Before making an application, you are requested to discuss your application with your line manager. External candidates will also be considered.

Explore our vacancies and find the right opportunity for you. Download the application form and email to the relevant contact person specified in the job advertisement.

Life Healthcare is an Equal Opportunity Employer. 

Please note that Life Healthcare has a mandatory Covid vaccination policy.

Only vaccinated external candidates will also be considered.

Thank you for your interest in this opportunity. Kindly note that only shortlisted candidates will be contacted.  Applicants who have not been contacted within two weeks of the closing date of this advert, should consider their application as unsuccessful.

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