What the job is: This job is for two Case Managers at Dr SK Matseke Memorial Private Hospital, part of Clinix Health Group. The role is based in Soweto, Gauteng, and involves managing patient cases to ensure proper billing and financial risk control. You will work closely with healthcare providers, funders, and hospital staff to support smooth operations in a private healthcare setting.

What you will do: You will plan, organize, and carry out case management tasks to ensure proper documentation and billing of patient care. This includes working with the reception team to obtain necessary authorizations for patient treatments. You will follow case management rules and standards to ensure all patient records are accurately coded using medical coding systems like IDC and CPT. Your role will also involve tracking patient treatments and updating funders (medical aids, government schemes, and insurance companies) about changes in care, length of stay, or medical interventions.

You will communicate daily with doctors, nurses, and other healthcare staff to understand patient conditions and treatments. You must ensure all patient records are complete and correctly categorized for timely hospital payments. If funders reject payment, you will follow proper resolution steps. Additionally, you will help maintain the hospital’s targets for work-in-progress (WIP) and discharged-not-yet-billed (DNYB) cases within required timeframes, such as completing cases within three days.

What you need: To qualify, you need a Diploma in General Nursing as the minimum requirement. You should have 3-5 years of experience as a hospital case manager, with knowledge of private healthcare systems. Advanced certification in medical coding or a Nursing degree is a plus. Important skills include understanding medical coding standards, using diagnostic tools like DRGs, and being computer literate to manage patient records and billing systems.

What you will get: This is a permanent full-time position at a private hospital in Soweto. While the salary range is not specified, the role offers stability in the healthcare industry and opportunities for professional growth in a supportive environment.