Are you a skilled Case Manager seeking a fresh challenge? 

Haven Health Management is looking for a detail‑oriented and proactive Case Manager to join our dynamic team, this is a Hybrid position however the candidate should preferably be based in Gauteng or Western Cape.

If you have a strong track record in managing cases efficiently, coordinating administrative processes, and are ready to make an impact, we would love to hear from you!

REQUIREMENTS, EXPERIENCE AND QUALIFICATIONS/TRAINING

• Diploma OR Degree in Clinical Field advantageous
• Minimum 2 year’s Case Management experience in Acute Rehab/Sub Acute
• Overall Minimum 5 years’ Case Management experience
• Intermediate knowledge and understanding of ICD 10 coding. (Certificate of completed course)
• Microsoft Office intermediate
• Strong understanding of funder rules, authorisation processes, and case management Experience billing of hospital accounts and EDI process.
• Good Time management and attention to detail skills
• Good communication skills
• Works well individually and in a Team

KEY DUTIES

• Authorisations: Pre-authorisation / update
• Communicate benefits to all relevant parties (LOS/LOC/funding exclusions)
• Prepare and discuss Private estimations with relevant parties.
• Benefit management and financial risk management.
• Capturing Pre- admissions / Admissions
• Discharge patient from system.
• Ensuring all relevant documents are saved on CARE-IS (operating system)  
• Ensure correct tariffs are authorised for applicable LOC.
• Liaise professionally with Stakeholders (internal/external)
• Billing of Hospital accounts
• EDI claims
• Funder escalations
• Attend daily Team meetings

If you're ready to be an integral part of our mission to improve health care access and patient outcomes and meet the above criteria, we want to hear from you, please ensure you have at least three (3) contactable references.  

 Should you not receive a response within two weeks after the closing date, kindly accept that your application has not been successful.