Job title: Medical Case Manager
Department: EMS Case Management and Billings
Based at: Head Office Roodepoort JHB
Reporting to: Business Operations Manager
Salary: Market related (EMS)

Job description:
Clinical assessment of all ambulances, flights and Doctors claims.
Coding of all the claims using ICD 10 Codes as per the medical aids schemes rules.
Billing of all the claims according to the rules and regulations set out by the different medical aids and insurance providers
Give advice to the service providers regarding claims payable and claims rejected by the medical aids or insurance providers
Deal with queries for short payments, rejections and unpaid claims by the schemes and insurance providers.

Requirements:
Matric/Grade 12
BLS or ILS Paramedic
3 years post graduate experience and patient care
Computer literate
Sound knowledge of medical aid schemes rules and legislature
ICD 10 code experience will be advantageous
Case management experience will be advantageous