Confirmations Clerk

1 week ago


Johannesburg, Gauteng, South Africa Mediclinic International Full time

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Wits Donald Gordon Med Centre | Parktown, Johannesburg | South Africa

Closing date: 07/04/2025
Number of positions: 1
Recruiter name: Masego Patricia Katane
Reference number: 58872
Workplace Type: On-site
Permanent

MAIN PURPOSE OF JOB

To minimise financial risk by ensuring authorisation and re-authorisation of all cases through effective communication between relevant parties.

KEY RESPONSIBILITY AREAS
  1. Obtain authorisation and re-authorisation for all identified patients to ensure fully paid claims
  2. Capture data and communicate to all parties
  3. Identify and refer risk cases to minimise financial risks
  4. Adhere to clinical coding standards as per Level 2 coding guideline
  5. Ensure compliance to the confirmation procedure contracts and legal aspects by utilising available resources and systems
REQUIRED EDUCATION

ESSENTIAL EDUCATION: Grade 12 or equivalent

DESIRED EDUCATION: None

REQUIRED EXPERIENCE

Essential minimum experience: 2 to 3 years experience in a similar role

DESIRED EXPERIENCE: Experience in Clinical Environment

REQUIRED JOB SKILLS AND KNOWLEDGE
  • Funder Contracts; Medical aid requirements/narrations
  • Patient admin programmes on the AS400 system
  • Rules and regulations regarding funder contracts
  • Clinical coding (Level 2 coding)
  • B2B EMS (electronic message system: check status of authorisations and use for troubleshooting)
  • Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.)
  • Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.)
  • Daily workflow; managing deviances; coding; and case management processes
  • Identify possible financial risks (e.g. no authorisation; insufficient LOS or LOC; etc.)

All applicants will be considered, with the understanding that preference will be given in accordance with the Employment Equity Plan of Mediclinic Southern Africa, as well as internal applicants/employees that meet the minimum requirements.

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