Case Manager | General Ward Jobs

About Life Healthcare

Our vision is to be a world-class provider of quality healthcare for everyone. We are a Black Economic Empowered (BEE) company and one of the largest healthcare providers in the country. Our culture is built on five core values: Passion for People, Quality, Performance Pride, Personal Care, and Lifetime Partnerships.

Job Overview: Case Manager (General Ward)

Location: Life Mercantile Hospital, South Africa
Reports to: Patient Services Manager
Job Type: Full-Time

We are looking for a Case Manager for our General Ward. In this role, you will manage the financial and clinical risks of patients. Your focus will be on ensuring accurate medical coding, providing clinical updates, and managing account submissions to help the hospital achieve its goals.

Key Responsibilities

Revenue Management

• Ensure all medical coding is accurate.
• Correctly apply and interpret RSRT (Refined Southern African Refined Triage) protocols.
• Participate in meetings to report financial losses and suggest ways to fix them.
• Monitor insurance verification and workflow processes.

Quality Control

• Conduct regular quality checks and take corrective action when needed.
• Implement and monitor programs to improve service quality.
• Follow patient service standards to meet hospital targets.
• Investigate complaints from both internal staff and external partners.

Operational Excellence

• Submit accurate patient accounts to medical funders on time.
• Update funders on the patient’s length of stay and level of care.
• Ensure compliance with company policies regarding authorizations and claims.
• Manage rejections or delays in payments.
• Ensure all billing checks are completed by the responsible departments.

Relationship Management

• Build strong relationships with doctors, staff, and external partners.
• Provide feedback and resolve concerns raised by stakeholders.
• Train relevant staff members on RSRT contracts.
• Escalate issues regarding doctor compliance or external funder concerns.

Requirements

• A Diploma or Degree in Nursing, Physiotherapy, Clinical Associates, or Paramedics (Critical Care or Emergency Care).
• Other qualifications covering Anatomy, Physiology, Pathophysiology, and Microbiology may be considered.
• Current registration with SANC (South African Nursing Council).
• Practical knowledge of hospital patient services and case management.
• Strong understanding of CPT and ICD coding.
• Knowledge of medical funder contracts, scheme rules, and benefits.
• Proficiency in using computers.

Professional Competencies

• Strong attention to detail and problem-solving skills.
• Resilience and the ability to work in a fast-paced environment.
• Excellent verbal and written communication.
• Professionalism and ethical behavior.
• A focus on customer service and building positive relationships.
• Strong organizational awareness and action-oriented mindset.

Application Details

Deadline: 10th March 2026

To apply, please visit the Life Healthcare careers website and submit your application through the official portal.