Overview

To coordinate and manage patient care, funding, and discharge processes to ensure quality clinical outcomes, appropriate resource utilization, accurate reimbursement, and compliance with hospital and medical scheme requirements.

Responsibilities

• Support the implementation of the hospital's Case Management strategy and contribute to departmental objectives.
• Coordinate multidisciplinary care and discharge planning by collaborating with patients, families, medical practitioners, nursing staff, and medical schemes.
• Manage relationships with funders, ensuring timely communication, authorization management, and resolution of funding queries.
• Apply clinical knowledge to accurately code diagnoses and procedures using ICD-10 and CPT standards.
• Monitor patient admissions, length of stay (LOS), level of care (LOC), and discharge processes to ensure appropriate utilization and reimbursement.
• Maintain service ...