Website Lenmed Private Hospitals
The Lenmed Group is a private hospital network operating across Southern Africa in South Africa, Botswana, and Mozambique, providing a broad range of medical and surgical disciplines, as well as 24-hour emergency care at all its acute facilities.
About Lenmed Private Hospitals
The Lenmed Group is a private hospital network operating across Southern Africa in South Africa, Botswana, and Mozambique, providing a broad range of medical and surgical disciplines, as well as 24-hour emergency care at all its acute facilities.
Main Focus Areas
The incumbent will be responsible for the liaison between the patient and medical aids in order to secure payment for the hospital.
Key Performance Areas: (include but are not limited to)
- Ensuring efficient management of a very complexed department
- All IR management to be handled efficiently
- Liaise network of internal and external stakeholders to ensure that managed care of patients is maintained
- Monitor and control costs for Managed Care Organization patients
- Confirm length of stay for all Managed Care Organizations patients
- Ensure correct coding is applied for all Managed Care Organization patients
- Assisting Clinicians and all Allied facilities with account queries
- Complying with governance and risk management requirements by ensuring to patient services policies and procedures.
- Ensuring correct application of ARM agreements on patient accounts
- Building and maintaining relationships with internal stakeholders
- Ensuring effective management of real time clinical updates, including requests, responses, rejections and submissions
- Ensuring effective Communication regarding funder requirements / responses to attending clinicians and patients where necessary compliance with industry standards
- Meeting targets of monthly cash collections / maintaining of DNYB days on 5 days and below.
Post Requirements: (include but are not limited to)
- B Degree Nursing Qualification or equivalent NQF level 6
- 3 years patient care experience and Case management will be an advantage
- Previous ICU / HC Case management experience will be an advantage
- Understanding of clinical coding, funder rules – advance coding an advantage
- Nursing policies and procedures
- SAP Experience preferably
- Must be available to work overtime where required
- Advanced Computer Literacy will be an advantage
- Good communication skills
- Good customer responsiveness
- Good time management skills
- Need to be able to work under pressure
To apply for this job please visit people.lenmed.co.za.
