Billing Operations Cluster BOC Confirmations Clerk

EdUpStairs; Pretoria; On-site; ZAR 180,000 - 240,000; Full time

Job summary

Netcare invites you to join a healthcare team as a confirmations clerk, handling authorisations, benefits verification and data entry for hospital billing. You will liaise with funders and internal managed care teams to ensure accurate patient billing and timely approvals.

The role requires care for confidentiality and accurate data handling. Based in Pretoria, you will work with case managers, file assessors and coders to improve workflow and reporting, while maintaining Netcare’s standards for

Qualifications

• Grade 12 or equivalent NQF Level 4 Qualification.
• Experience in a healthcare setting.
• Experience with any clinical or healthcare related billing systems.
• Computer literacy required.

Responsibilities

• Confirm that medical aid authorisations are in place for hospital admission.
• Follow up on outstanding authorisations and ensure timely processing.
• Ensure information from insurance providers is entered accurately in the SAP system.
• Control data quality to support accurate billing reports.
• Collaborate with case management and billing teams to ensure smooth workflow.

Skills

Customer Focus

Personal Work Ethic

Building Relationships

Communication

Teamwork

Technical Knowledge

Education

Grade 12 or equivalent

Tools

Computer literacy

Job description

We provide meaningful careers that connect people with purpose.

We are united by a common purpose of providing the best and safest care; and by our shared values of Care, Truth, Participation, Compassion and Dignity.

Netcare invites you to be part of our journey.

ROLE SUMMARY

The confirmations clerk communicates with funders and internal managed healthcare teams regarding confirmations of authorisations and available benefits. The incumbent will be responsible for confirming authorisations, length of stay, clinical codes and level of care for patients.

KEY WORK OUTPUT AND ACCOUNTABILITIES

DISRUPTIVE INNOVATION

Confirmations process

• Manage that all medical aid patients have the necessary authorisation for hospital admission.
• Systematic follow-up of all outstanding authorisations.
• Ensure all relevant information received from the insurance provider is accurately reflected on the SAP system.
• Control of incomplete, inaccurate and delayed confirmation data as these have ramifications for accurate reporting of billing financials.
• Working within day end parameters to ensure that there is flow of files from case management to final billing.
• Manage and elevate outstanding funder responses.
• Secure requested letter of motivations from doctors when applicable.
• Collaborate with the Hospital Billing Coordinator on following up outstanding hospital documentation.

Communication

• Maintain Netcare digital system of communications strictly.
• Be courteous and professional in all interactions with funders and other stakeholders.

General

• Assist with any adhoc duties assigned by the BOC Case Manager/ Billings Manager.
• Work collaboratively alongside case managers, file assessors and coders for effective task resolution.
• Be agile in approach as Netcare moves to digitally enabled systems.

TRANSFORMATION OF OUR SOCIETY

Personal and professional development

• Assume responsibility for own personal and professional development.
• Keep up to date with Netcare’s evolving policies and procedures.
• Maintain and sustain effective working relationships with all customers and colleagues.

BEST AND SAFEST PRACTICE

POPIA

• Always maintain patient confidentiality.

SKILLS PROFILE

EDUCATION

Required

• Grade 12 or equivalent NQF Level 4 Qualification.

WORK EXPERIENCE

Required

• Experience in a healthcare setting.
• Experience with any clinical or healthcare related billing systems.

KNOWLEDGE

Required

• Computer literacy

PHYSICAL REQUIREMENTS

• In the event of any physical or psychological limitation that may impair the employee’s ability to perform the required job function, the employee must consult the employer for reasonable accommodation.

SKILLS

Customer Focus and Service Delivery

• The capacity to identify and respond to the needs of internal and external customers.

Personal Work Ethic

• Capacity to instil an ethic of quality and consistency in self and others.

Building Relationships

• Capacity to establish constructive and effective relationships.

Communication

• The capacity to clearly present information, either written or verbal.

Teamwork

• Capacity to cooperate with others to work towards a common goal.

Technical Knowledge

• The capacity to perform a technical function to required standards.

WORKING CONDITIONS

• Professional flexibility in working hours while supporting daily business operations which may include weekends and night shifts where applicable.
• Will interact with internal and external customers through several different means.

NETCARE VALUES AND BEHAVIOURS

Netcare Values

At Netcare, our core value is care. We care about the dignity of our patients and all members of the Netcare family. We care about the participation of our people and our partners in everything we do. We care about truth in all our actions. We are passionate about quality care and professional excellence.

• At Netcare, our core value is care.
• We care about the dignity of our patients and all members of the Netcare family.
• We care about the participation of our people and our healthcare partners in everything that we do.
• We care about the truth in all our actions.
• We listen with empathy and respond with acts of compassion in all interactions with our patients and their families.

The Netcare Way

Netcare is committed to providing quality care. Our basic service standard holds us accountable for the below seven behaviours which you will be accountable to uphold:

• Respect - I always greet everyone to show my respect.
• Identity - I always wear my name badge to show my identity.
• Dignity - I always treat others with consideration and humility to uphold dignity
• Care - I always act in the best interest of Netcare and others to show I care
• Compassion - I always listen with empathy and respond with kind action to show my compassion
• Appreciation - I always say thank you to show my appreciation.
• Diversity- I always embrace diversity to strengthen inclusivity and belonging.

Join the team committed to providing the best and safest health and care.

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