Case Management Officer

Job Summary

Case Management Officer  (Patient Financial Services Officer) - Responsible for performing eligibility verification, maintains proper pricing and authorization practices for proposed services, reviewing financial documentation, validation of coding appropriateness and financial clearance activities to maintain continuity of in-patient billing processes.

Key Responsibilities

• Receives elective admission requests from clinics’ teams and physician referrals.
• Determine if patients are eligible for treatment prior to provision of services.
• Eligibility, Authorization and cost estimation:
  • Documentation and Coding Support
  • Financial Counselling
  • Enhance clinical efficiency, cost effectiveness and patient experience.

Minimum Job Requirements 

• Bachelor degree in Nursing.  
• 2-4 years of clinical experience.
• 1-3 years medical insurance experience.  

Skills

• Excellent written and verbal communication skills.
• Incident/accident reporting procedures.
• Competencies in data entry & analysis.
• Organizational, time-management, computer and administrative skills.
• Good Knowledge in email etiquette.