Case Manager
A Case Manager (General) vacancy exists at Eden Gardens Private Hospital, reporting to the Case Manager/Billings Supervisor. The successful candidates will be responsible efficient patient case management and the delivery of an efficient and professional service to the internal and external customers.
Key Responsibilities:
• Carry out clinical coding in accordance with CPT and ICD requirements.
• Ensure that pre-admission and pre-authorisation information is accurate and in accordance with hospital and funder procedures.
• Maintain patients’ clinical status in accordance with funder approval requirements for the duration of hospitalization; keeping patients informed and managing the entire hospital stays’ financial risk.
• Provide complete and accurate updates and discharge information of all accounts.
• Maintaining accurate accounts of all admissions. • Handle patient files in accordance with hospital procedures.
• Timeous electronic submission of accounts and follow up on short payments arising from case management related issues.
• Ensure the adherence of hospital staff to funder rules and coding procedures. • Keep well informed on legislation pertaining to funders and related Health Care matters.
Minimum Requirements:
• SANC registration as a nurse. 2-3 years’ experience as a case manager either at hospital level or with the Medical Schemes (preferably case management experience at hospital level)
• Experience with Medical Aid administration procedures (ICD10, CPT 4 Procedure Codes and Per Diems).
• Knowledge of hospital billing and tariffs and Hospital Information System will be advantageous.
• Ability to build good relations with various internal and external stakeholders.
• Computer proficiency. Competencies
• Problem-solving, analysis and judgement
• Verbal and written communication
• Attention to detail
• Resilience •
Engaging diversity
• Professional and technical proficiency
• Adaptability
• Building relationships
• Customer responsiveness
• Organisational awareness
• Ethical behaviour
• Excellence orientation
• Critical thinking
• Planning and organizing
• Teamwork
Closing date : 20 October 2026 Interested candidates who meet the minimum requirements are invited to apply by forwarding a comprehensive CV by close of business on to Email: Recruitment@edengph.co.za ; Tel: 0338154600
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If this position is not suitable for you, you can view other employment opportunities by visiting our Vacancies page.
Eden Gardens Private Hospital welcomes applications from suitably qualified candidates for advertised positions and is committed to maintaining a professional working environment.
For more information about Eden Gardens Private Hospital and the healthcare services available in Pietermaritzburg, explore the rest of our website or contact us directly.
