Job Description
MAIN PURPOSE OF JOB
Effectively and efficiently manage the hospital case management process and facilitate the communication process between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation
KEY RESPONSIBILITY AREAS
Effective coordination of patient care plans to minimise financial risk for the companyEffectively manage the quality of clinical documentationProvide clinical expertise for managing insurance claims with the supportive medical justifications based on good clinical practiceFocus on continuous quality improvement of clinical documentationConduct concurrent and retrospective utilization reviews to ensure medical necessity, appropriate level of care, and compliance with payer requirements.Monitor Length of Stay (LOS) and facilitate timely discharge planning.Coordinat...