Case Manager - Pretoria Verfied

R 26600 - 27500 per month Pretoria, Gauteng Pretoria, Gauteng more than 14 days ago 20-04-2016 10:50:30 AM
18-05-2016 10:50:30 AM
Pretoria, R26 667 - R27 500 Per Month
Benefits: Medical Aid, Pension, Parking
Job Type: Permanent
Sectors: Call Centre, Medical Job Details
Responsible for - delivery of an effective call centre service in order to achieve member satisfaction

to assist the client by approving appropriate funding

to deliver affordable Managed Healthcare services

to reduce the risk associated with hospitalization and to provide an effective and unique managed healthcare Candidate Requirements
B Cur degree / Diploma in Nursing
Medical Scheme – related experience in Hospital Benefit Management
1+ years’ experience gained in the medical funding industry
Knowledge of the current coding structures in the South African Health Care environment i.e. ICD10’s, CPT4, NRPL, and PMB conditions, protocols and Scheme rules Thorough, well-grounded clinical knowledge of Pre Authorization of hospital admissions and Case Management of hospital cases in order to take cost-effective and appropriate decisions in evaluating treatment, LOS and LOC.