Clinical Coding Specialist

3 weeks ago


Sandton, South Africa Discovery Limited Full time

Discovery's core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best. As global thought leaders, Discovery is passionate about innovating in order to not only achieve financial success, but to ignite positive and meaningful change within our society.

About Clinical Coding Intelligence

Clinical Coding Intelligence's purpose is to deliver world class clinical coding intelligence and strategic application to any area of the Group's business in which clinical data (diagnoses, procedures/interventions, pharmaceuticals etc) is represented in standardised terminology coded format. This skillset is globally rare and relies on multiple years of experience and exposure to international standards, principles and world-class terminology organisations. This is further pivoted on the ability to discern where efficiencies can be gained and intelligence distilled within the most valuable currency in modern-day healthcare, that being good quality clinical data.

Key Purpose

To maintain full responsibility and accountability for all clinical coding/terminology initiatives and business requirements for the Discovery/Vitality Group including but not limited to Discovery Health and Amplify Health.

Areas of responsibility may include but not limited to:

  • To ensure regulatory compliance to industry coding standards as they apply to each geographical region.
  • To ensure appropriate use of coding schemas (according to national and international guidelines) towards collecting high quality clinical data for the strategic support of benefits/limits, disease profiling, analytics and the development of critical risk management tools.
  • To ensure that clinical codes facilitate effective systems and operational processes, across/between all business areas, as well as with external partners.
  • To ensure continued upskilling within the Group of this scarce specialist skill, ensuring business continuity and stimulating leading edge coding innovations.
  • To continue to build on (and actively contribute to) the Discovery/Vitality Group's reputation as a globally recognised Clinical Coding Centre of Excellence.
  • To partner with international terminology and academic institutions to stay abreast of, and contribute to, international coding initiatives.
  • To represent the Coding Intelligence team across all relevant internal business areas, as well as externally to clients and terminology organisations.
  • To actively contribute to strategic decisions related to Clinical Coding in support of the Group's business objectives Implementation: projects, initiatives and organisational changes.

Personal Attributes and Skills

  • Values Driven
  • Learns on the Fly
  • Resilient
  • Instils Trust
  • People Savvy
  • Drives Results
  • Strategic thinker
  • Stakeholder Management

Technical Skills or Knowledge

  • Written and Verbal Communication
  • Presentation Skills
  • Analytical skills
  • Project Management
  • Negotiation Skills
  • MS Office
  • Clinical Coding Expertise/Skills in International Classifications and Terminologies

Education and Experience

  • Bachelor's degree in a medical capacity (e.g. Nursing, Physiotherapy, Clinical Technology) is essential.
  • Additional qualification within the field of Health Informatics (Advantageous).
  • International coding accreditation such as CPC (Certified Professional Coder) with AAPC (American Academy of Professional Coders) or CCS (Certified Coding Specialist) with AHIMA (Advantageous).

Work Experience

  • 10 years working experience in similar or same role.
  • Strategic experience within a clinical coding environment, particularly in the field of health insurance.

EMPLOYMENT EQUITY
The Company's approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.

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