Case Coordinator

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Case Coordinator   N/A   Harare

Wanted is a Case Coordinator to join an organisation in the N/A sector in Harare . Candidates invited to apply.  

Applications Received:  3    Job Posted: 2021-01-13 08:07:06    Job Updated: 2021-01-14 01:17:50    Job Status: Receiving Applications (Open)


(0 % (Receiving Applications (Open)))

Requirements

Years of Experience: 2


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Job Description:

Main Duties:

  • Analyses all requests submitted by service providers, members and ensure correct awards are given on quotations for procedures.
  • Checks on the correct use of tariffs on quotations and rejects where services are inappropriate.
  • Captures all the Cases on the system and issues Personal Identification Numbers to cases admitted.
  • Advises members and service providers on awards payable.
  • Receives and resolves preauthorization queries from services providers and members.
  • Attend to walk-in clients and manage the front office desks.
  • Escalates complicated queries and complaints to Team Lead Case Coordination.
  • Refers chronic cases and high cost cases to the Disease Management team for further follow up.
  • Initiate Case submissions on appeals from members and service providers for approval by the Head Managed Care.
  • Refers Cases of over-servicing and suspected fraudulent activities to Team Lead Case Coordination for further analysis.
  • Prepares and submits monthly reports to the Team Lead Case Coordination on preauthorised Cases.

Qualifications:

  • Diploma in Nursing/Health Sciences or the equivalent
  • At least 2 years case management experience


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Case Coordinator salary range



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