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Vacancy Details
 
A job opportunity

A job opportunity exists for the right candidate in Western Cape
The Department of Health and Wellness is guided by the principles of Employment Equity. Candidates with disabilities are encouraged to apply and an indication in the regard will be appreciated.

Note: No payment of any kind is required when applying for any of the positions advertised by the Western Cape Government.
 
Case Manager
  Employment Type: Permanent
  Reference No: HO120/2019
  Directorate: Management Accounting, Head Office Cape Town
 
Requirements
A health related qualification registrable with the Health Professions Council of South Africa (HPCSA) or South African Nursing Council (SANC).
 
Experience:
Appropriate experience in Case Management/Medical Aid Environment or Revenue Generation.
 
Duties (key result areas/outputs):
Assist various institutions with clearing of externally funded revenue back logs related to ICD-10 code assignment, UPFS assignment and the management of PMB conditions. Assist various Hospital Fees Departments with follow-up of outstanding medical scheme and state department balances and account queries. Conduct clinical audits of patient accounts to ensure accuracy of invoices for submission to medical aids and state departments. Perform operational Case Management functions at various institutions inclusive of pre-authorisation and clinical review to ensure compliance with Case Management policies and procedures. Assist with EDI rejections to ensure timeous submission of medical scheme invoices. Provide quotations to H2, H3 and Foreign patients. Assist with the implementation of departmental case management policies and procedures by providing onsite skills development and training of relevant role players in matters relating to Case management.
 
Competencies (knowledge/skills):
Good knowledge of the Uniform Patient Fees Schedule (UPFS), Managed Health Care or Hospital. Information Systems and EDI (Electronic Data Interchange). Knowledge of the Medical Schemes Act 131 of 1998 and the application of Prescribed Minimum Benefit (PMB) legislation i.e. the Chronic Disease List (CDL) and Diagnostic Treatment Pairs (DTP). Experience in ICD-10 Code assignment and the ability to link patient diagnosis with procedural codes. Ability to work with Excel spread sheets, Microsoft Word and web based programs (medical aids).
 
Enquiries:
Ms L Ismail, tel. no. (072) 601-6586
 
Inherent requirement of the job:
Willingness to travel and spend long periods away from the office. Valid (Code B/EB) driver’s licence.
 
 
 
 
Remuneration:
R 316 791 - R 373 167 Annual salary plus service benefits (13th cheque, employer's contribution to the pension fund, housing and medical aid allowance).
 
Starting Date:
10/18/2019 12:00:00 AM
 
NOTICE TO ALL
Candidates may be subjected to a competency test. No payment of any kind is required when applying for this post. As directed by the Department of Public Service and Administration, applicants must note that further checks will be conducted once they are shortlisted and that their appointment is subject to positive outcomes on these checks, which include security clearance, qualification verification, criminal records and previous employment.
  • It will be expected of shortlisted candidates to be:
  • available at the venue on the time and date as determined by the Department and
  • bring along recently (not older than 6 months) certified copies of your Identity Document (ID), driver’s license (if applicable for the post), qualification and/or proof of registration at relevant statutory body. Failure to adhere to the aforementioned may lead to his/her application being disqualified and not further considered.
Closing date: 11/8/2019 12:00:00 AM
 
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