The incumbent will be responsible for the liaison between the patient and medical aids in order to secure payment for the hospital
Requirements
- Registered with SANC as a Registered Nurse / Enrolled Nurse
- 4 - 5 years working with finance and Medical Aid Administration
- Experience working within a Hospital will be an advantage
- Advanced Computer Literacy
- Clinical coding knowledge
- Knowledge of clinical terminology and anatomy, funder rules, co-payments and exclusions
- Liaise network of internal and external stakeholders to ensure that managed care of patients is maintained
- Monitor and control costs for managed Care Organization patients
- Confirm length of stay for full Managed Care Organization patients
- Accompany managed Care Organization Case Managers on ward rounds in the hospital
- Assist with final authorisation of managed care patient files
- Ensure correct coding for all Managed Care Organization patients
- Supply all details regarding history to clinical partners
