Case Management Officer

About the role

The Case Management Officer, also known as Patient Financial Services Officer, ensures eligibility verification, proper pricing, and authorization for proposed services. The role reviews financial documentation, validates coding appropriateness, and performs financial clearance to support continuous inpatient billing processes.

Key responsibilities

• Receive elective admission requests from clinic teams and physician referrals.
• Determine patient eligibility for treatment before services are provided.
• Perform eligibility, authorization, and cost estimation activities.
• Provide documentation and coding support.
• Offer financial counselling to patients.
• Enhance clinical efficiency, cost‑effectiveness, and patient experience.

Required profile

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

Required skills

• Excellent written and verbal communication.
• Knowledge of incident/accident reporting procedures.
• Competency in data entry and analysis.
• Strong organizational, time‑management, computer, and administrative abilities.
• Good knowledge of email etiquette.