Confirmations Clerk
1 week ago
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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
To minimise financial risk by ensuring authorisation and re-authorisation of all cases through effective communication between relevant parties.
KEY RESPONSIBILITY AREAS- Obtain authorisation and re-authorisation for all identified patients to ensure fully paid claims
- Capture data and communicate to all parties
- Identify and refer risk cases to minimise financial risks
- Adhere to clinical coding standards as per Level 2 coding guideline
- Ensure compliance to the confirmation procedure contracts and legal aspects by utilising available resources and systems
ESSENTIAL EDUCATION: Grade 12 or equivalent
DESIRED EDUCATION: None
REQUIRED EXPERIENCEEssential 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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