- Reference Number : REFS/013059
- Directorate : Finance Department
- Number of Posts : 1
- Package : R 321 543.00-R 378 765.00-per annum(plus benefits)
- Enquiries : Mr P Molalogi (012) 529 3081
- A Health related diploma or degree registrable with the South African Nursing Council (SANC) or Health Professions Council of South Africa (HPCSA).Appropriate experience in Case Management / Medical Aid environment and Revenue Generation,Willingness to work overtime.Good knowledge of the Uniform Patient Fees Schedule (UPFS), Managed Health Care or Hospital Knowledge of 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) Excellent communication, conflict management, interpersonal and leadership skills Ability to communicate (written and verbally) in English and at least two of the official languages.
- Perform Case Management functions, i.e. assist with authorisation, concurrent, retrospective review, discharge planning and liaison with various role players and third parties to monitor utilization. Provide quotations to H2, H3 and Foreign patients. Assist with assignment of ICD-10 codes when required and identification of PMB conditions. Manage and implement Case Management policies, protocols and procedures in the hospital, (including providing the necessary on-site skills development and training of all relevant role players). Conduct clinical audits of patient accounts inclusive of medical aids, State Departments, e.g. RAF and COIDA to ensure accuracy of invoices with regards to ICD 10 codes, UPFS procedure codes and resource utilization. Provide support in terms of hospital account queries and assist with follow up of outstanding medical scheme balances (Medikredit EDI reports). Supervision of staff and liaison with relevant role players in matters relating to Case management.
- From 1 January 2021 should an application be received using the incorrect application form employment (Z83), Applications must be submitted on the new updated Z83 form obtainable from any Public Service Department or from the website and must be completed in full; failure to do so will result in your application being not considered. The fully completed new z83 form should be accompanied by recent CV as well as copies of all qualifications, ID document/Smart ID. ONLY SHORTLISTED CANDIDATES WILL BE REQUESTED TO SUBMIT CERTIFIED DOCUMENTS. Please ensure that the specific reference number is quoted correctly. Applications can be delivered to: Dr. George Mukhari Academic Hospital, 3111 Setlogelo Drive, Ga-Rankuwa, 0208 Nurses Home Block 13(HR Registry) or posted to: Dr. George Mukhari Academic Hospital, Private Bag X422, Pretoria 0001 or Apply online at www.gautengonline.gov.za. Correspondence will be entered with shortlisted candidates only and if you are not contacted within 3 months after closing date please accept that your application was unsuccessful. The employer reserves the right to fill this position. It is legislative requirement that all newly appointed staff members be subjected to Personnel Suitability Check (PSC)- Verification, upon appointment within the department. This verification processes entails reference checks, identity verification, qualification verification, criminal records checks. Successful candidates will be subjected to OHS medical surveillance as required by HBA regulations within OHS Act 85 of 1993.
Employer : Department of Health
Location : Dr George Mukhari Academic Hospital
Closing Date : 11-02-2022
|Do you have a health related diploma or degree registrable with the South African Nursing Council (SANC) or Health Professions Council of South Africa (HPCSA).|
|Do you have an appropriate experience in Case Management / Medical Aid environment and Revenue Generation.|
Please Notes :
- Due to the large number of applications we envisage receiving, applications will not be acknowledged. If you do not receive any response within 3 months, please accept that your application was not successful.