Case Manager (Clinical Coding) at Private Hospital Group in Durban
Glasshouse Recruiting · Durban, KwaZulu Natal
Overview
A private hospital group in Durban is looking for a Case Manager with strong clinical knowledge and coding skills. You will use your nursing and case management experience to justify hospitalisation, communicate with medical aids, and ensure accurate coding so that patients are billed correctly. This is a permanent, full time role for someone who understands the managed health care environment and enjoys working with clinical and financial details.
About the role
As a Case Manager, you will play a key role in bridging clinical care and financial risk management. Using your clinical expertise, you will review and justify patient hospitalisation in terms of treatment, length of stay, and level of care. You will work closely with medical aids and internal stakeholders to ensure smooth authorisation and billing processes.
This role suits someone who is detail oriented, confident in clinical coding, and comfortable communicating with funders. You will be part of a hospital group that values accurate administration and effective risk management.
Application note: This position is advertised by Glasshouse Recruiting on behalf of a hospital group in Durban. No specific application instructions or closing date were provided in the listing. Please prepare your CV and supporting documents and apply through the relevant channel.
Requirements
- B Degree or Diploma in Nursing
- Case Management qualification and/or case management experience
- Diverse clinical nursing experience
- ICD-10 and CPT coding qualification or experience
- SAP IS-H experience advantageous
- Proficiency in Microsoft Office products
- Good communication and interpersonal skills
Responsibilities
- Apply clinical knowledge to justify patient hospitalisation in terms of treatment, length of stay, and level of care
- Monitor and action risks related to medical aid benefits and hospitalisation
- Ensure accurate, specific, and comprehensive clinical coding
- Communicate timeously and effectively with medical aids and follow up on authorisations
- Review authorisation aspects, mitigate financial risk, and release cases for billing
- Liaise with internal and external stakeholders regarding patient treatment
- Adhere to the Managed Health Care rules of engagement and relevant industry legislation
Job details
- Organisation
- Glasshouse Recruiting
- Location
- Durban, KwaZulu Natal
- Job type
- Full time
- Experience level
- Mid
- Education
- Diploma
- Category
- Healthcare & Nursing
- Application Method
- Apply manually
Success Guide
As a Case Manager in a hospital group, you will be the link between doctors, patients, and medical aids, making sure that hospital stays are clinically justified and correctly coded. For your application, highlight your nursing background and any specific training or experience in ICD-10 and CPT coding. If you have worked with medical aid authorisations or SAP IS-H, mention this clearly. In an interview, be ready to discuss how you handle pressure from funders while maintaining patient care. This role values accuracy and confidence, so show examples of how you have solved coding or authorisation issues in the past.
How we help you prepare
This employer takes applications on their own website, so you'll submit this one yourself — but SPAAN NOW gets everything ready for you first. Here's how it works:
- Our AI tailors your CV to match this job's keywords and requirements, so it stands out to recruiters and screening systems.
- A custom cover letter is written specifically for this role — no generic templates.
- We gather the documents this job needs: CV, Diploma certificate, Degree certificate, Case Management qualification and ICD-10/CPT Coding certificate. SPAAN NOW pulls these from your profile and packages them together, ready to attach.
- Once your application is prepared, we show you exactly how and where to apply — just follow the link to the employer and submit your ready-made CV, cover letter and documents.
- Mark it as applied under Applications to keep track, and if you're shortlisted, use AI Interview Prep to practise questions commonly asked for roles like this.
We do the hard part — tailoring and gathering everything — so applying yourself only takes a minute.
Spaan Talk
Nobody has said anything yet. Be the first.