Case Manager – Medicare Private Hospital at Africa Health Care

Description


A vacancy exists for a Case Manager, reporting to the Patient Administration Manager. The position's primary responsibilities include efficient patient case management and the delivery of an efficient and professional service to the internal and external customers. The successful candidate will be goal oriented with strong customer, quality, and performance focus.


Critical Outputs


Carry out clinical coding in accordance with CPT and ICD requirements
Ensure that pre-admission and pre-authorisation information is accurate and in accordance with hospital and funder procedures.
Maintain patients' clinical status in accordance with funder approval requirements for the duration of hospitalization; keeping patients informed and managing the entire hospital stays' financial risk
Provide complete and accurate updates and discharge information of all accounts
Maintaining accurate accounts of all admissions
Handle patient files in accordance with hospital procedures
Timeous electronic submission of accounts and follow up on short payments arising from case management related issues.
Ensure the adherence of hospital staff to funder rules and coding procedures
Keep well informed on legislation pertaining to funders and related Health Care matters


Requirements


SANC registration as an RN
High school matric certificate
3 - 5 years' experience of basic finance and Medical Aid administration procedures will be an advantage
Knowledge of hospital billing and tariffs would be an advantage.
Have sound computer literacy skills and working knowledge of MS office, word and excel.
Excellent communication skills and the ability to form and build strong partnerships
Excellent negotiation skills & the ability to interact with tact and diplomacy


Competencies


Collaboration/ Relationship Building
Problem-solving, analysis and judgement
Resilience
Engaging diversity
Verbal & written communication and presentation skills
Customer responsiveness
Organisational awareness
Excellence and quality orientation
Ethical behaviour
Decision making


Closing: 2026-05-21