Admissions Administrator

Life Healthcare Group (Pty) Ltd

Admissions Administrator

Life Healthcare Group (Pty) Ltd • Johannesburg • via Pnet

Introduction

There is a vacancy for a Field Case Manager, reporting to the Regional Finance Manager.

The selected candidate will be responsible for managing the administrative, financial, and clinical risks of patients in general and specialist units across several hospitals in the West Coast region.

The candidate will be accountable for Case Management outcomes and will be assigned to different hospitals in the Western Cape based on care needs identified by the Regional Finance Managers.

Critical Results

Ensure operational excellence by:

• Conducting ward rounds and ensuring the complete and accurate collection of clinical data from patient records, as well as communicating with nursing and clinical staff. • Update accurate clinical information to justify length of stay and level of care to medical funds for cases in specialized units and, when operationally necessary, for cases in general wards.
• Update and provide necessary information to funders regarding high-value items, limited-benefit items, and protocols, as defined by managed care organizations.
• Communicate funder requirements and responses to physicians and patients as needed, and ensure compliance with industry standards.
• Ensure the efficient management of real-time and manual messaging, including requests, responses, rejections, and submissions.
• Ensure the accurate presentation of accounts to funders.
• Comply with governance and risk management requirements, ensuring adherence to patient service policies and procedures.
• Ensure compliance with service level agreements with internal and external stakeholders. Ensure effective revenue management by:
• Ensuring accurate and complete coding of patient accounts.
• Ensuring the correct application and interpretation of funders’ RSRT contracts and FFS claims.
• Reporting identified RSRT risks to the appropriate managers.

Ensure effective quality outcome management by:

• Adhering to patient service escalation processes and customer service standards.
• Investigating and reporting published alert incidents and agreeing on appropriate actions with internal and external stakeholders.

Ensuring effective internal and external stakeholder relationship management by:

• Establishing and maintaining relationships with internal stakeholders.
• Providing and facilitating training on RSRT contracts.
• Providing feedback and information on concerns or issues raised by external stakeholders. • Provide feedback to external stakeholders that affect the efficiency and effectiveness of the case management process.
• Escalate physician non-compliance with the RSRT framework to RSRT meetings.

Requirements

• Diploma or degree in Nursing, Physiotherapy, Clinical Associate, Paramedic (such as Critical Care Assistant or Emergency Care Professional), or any other qualification covering anatomy, physiology, pathophysiology, and microbiology as core courses. Demonstrated experience in leadership, change management, and staff management.
• Current registration with the relevant professional/regulatory body (South African Council of Nurses).
• Knowledge of clinical coding, terminology, clinical anatomy, funding regulations, co-payments, and exclusions.
• Working knowledge of COID.
• Knowledge of business and change management principles.
• Computer proficiency.
• Willingness to travel.
• Valid driver’s license. Competencies:
• Problem-solving, analytical, and sound judgment.
• Resilience.
• Integration with diversity.
• Verbal and written communication and presentation skills.
• Influence.
• Drive and energy.
• Commitment to excellence.
• Ethical behavior.
• Relationship building.
• Customer service.
• Organizational awareness.
• Leading by example.
• Motivation and staff development.

Email:

nicola.vandeventer@lifehealthcare.co.za

Application Deadline:

Friday, March 20, 2026