Applications are invited from persons who possess the requisite experience, and qualifications and suitably meet the corresponding requirements for this mission-critical vacant role.
This position reports to the Patient Administration Manager.
Closing date: 18 July 2023
Contact: Sanmarie Marais
Tel: (012) 423-4033 | E-Mail: sanmariem@urology.co.za
KEY AREAS OF RESPONSIBILITY
- Responsible for the case management process within the hospital.
- Interacts with medical schemes to ensure that authorisations are provided timeously.
- Verification of clinical coding.
- Ensures accurate application and interpretation of specialised wards criteria.
- Provides support for the management of alternative fee structures.
- Liaison with doctors on funder requirements when necessary.
- Continuous performance and quality management.
- Interpretation and implementation of scheme benefit rules.
- Maintains client service principles to ensure client expectations are met.
REQUIREMENTS
- Registered with the South African Nursing Council as an Enrolled Nurse or Professional Nurse.
- Experience in a Managed Healthcare environment.
- Knowledge of coding and coding regulations.
- Intermediate knowledge of Microsoft Office suite.
- Knowledge of the rules and regulations regarding medical aid schemes.
- Knowledge of Trifour system will be an advantage.
- Independent problem-solving and decision-making skills.
- Good accuracy and attention to detail skills to maintain high standards of work output.
- Ability to function well within a team.
- Understands the interrelationships between business processes.
- Maintains a customer-focused mindset that acknowledges the value of the customer.
GENERAL NOTE: Please note that the Urology Hospital is a smoking-free facility and an equal-opportunity employer. Should you not hear from us within fourteen working days after the closing date please consider your application as unsuccessful. POPIA sections provide that everyone has the right to privacy and it includes a right to protection against the unlawful collection, retention, dissemination, and use of personal information and any attached text or documentation that are retained by the Urolocare hospitals for a period in accordance with relevant data legislation.
