LetsLink Medical Recruitment
Healthcare, Medical and Pharmaceutical Industry
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Pharmacy Case Manager job vacancy in Port Elizabeth.
LetsLink recruitment is currently seeking for a Pharmacy Case Manager to work at a private hospital in Gqeberha. The successful candidate will be responsible for liaising between patients and medical aids to ensure payment for hospital services.
Key Responsibilities:
- Ensure accurate and up-to-date information is entered into the Hospital Billing System
- Provide patient history details to clinical partners
- Monitor and control costs for managed care patients
- Confirm length of stay for managed care patients
- Participate in ward rounds to collect clinical information and provide updates to funders
- Release patient files
- Ensure correct coding (ICD and CPT) for all managed care patients
- Assist the Hospital Clinical Coder with clinical information to ensure accurate coding
- Consult with relevant service providers regarding patient care treatment
- Assist with patient transfers to rehab hospitals or step-down facilities
- Liaise with internal and external stakeholders to maintain managed care for patients
- Participate in in-service training provided by the organization
- Maintain a satisfactory level of skill and knowledge through professional development
- Work collaboratively with others to establish and maintain good working relationships
- Actively participate as a member of a team to achieve goals
- Maintain professional flexibility in working hours while supporting daily business hours
- Review accounts for short payments/Debt pack
Requirements:
- Registered or Enrolled Nurse qualification or equivalent NQF level 4
- Computer literacy
- Must be registered with the SANC or professional body
- Previous hospital or medical scheme case management experience is advantageous
- Experience in IDC 10 and CPT coding is advantageous
- Minimum of 3 to 4 years of experience in a multidisciplinary environment
- Ability to develop and maintain clinical knowledge
- Knowledge of case management skills and expertise
- Familiarity with nursing and pharmacy policies and procedures
- Understanding of managed healthcare experience
- ICD 10 and CCSA coding experience/qualification