Clinical Assessor

Mediclinic International; Bellville; Hybrid; ZAR 200,000 - 300,000; Full time

Job summary

A leading healthcare provider in Bellville, South Africa is seeking a candidate to minimize operational and financial risks by ensuring correct clinical coding and appropriate levels of care. Applicants must have a relevant clinical qualification and experience in the medical services environment. The role offers hybrid working conditions and values compliance with legal standards in clinical practice.

Qualifications

• Experience within the Medical Services environment.
• Experience in a clinical role.
• Experience in EMS healthcare environment.

Responsibilities

• Minimise financial risk by assessing Patient Report Form.
• Ensure compliance to contracts and Clinical Practice Guidelines.
• Finalise cases for reimbursements from funders.

Skills

Clinical knowledge in emergency medical services

Competence on SAP

Data Analysis

Computer literacy

Education

Relevant Clinical Qualification

Tools

SAP

Job description

Choose how often (in days) you want to receive a notification:

Mediclinic Southern Africa Corporate Office| Bellville, Cape Town | South Africa

Closing date: 21/08/2025
Number of positions: 1
Recruiter name: Zimkhitha Wulana
Reference number: 62788
Workplace Type:Hybrid
Permanent

Please note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profile

MAIN PURPOSE OF JOB

To minimise operational and financial risk by ensuring the correct allocation of clinical coding and the appropriate level of care for all cases.

KEY RESPONSIBILITY AREAS

• Minimise the financial risk by effectively assessing the Patient Report Form to ensure the correct Level of Care is allocated
• Ensure compliance to contracts, legal aspects and Clinical Practice Guidelines by utilising available resources and systems
• Apply clinical coding and ensure that coding standards are adhered to
• Ensure correct and timeous finalisation of cases to facilitate reimbursements from funders
• Identify and refer gaps or risk in clinical practice to minimise operational and financial risks and participate in quality enhancement projects that will improve the quality of clinical information documented as well as improve patient care

REQUIRED EDUCATION

ESSENTIAL EDUCATION:

• Relevant Clinical Qualification

DESIRED EDUCATION:

• EMS Qualified

REQUIRED EXPERIENCE

ESSENTIAL MINIMUM EXPERIENCE:

• Experience within the Medical Services environment

DESIRED EXPERIENCE:

• Experience in a clinical role; Experience in EMS healthcare environment; Medical aid background; Clinical Coding

REQUIRED JOB SKILLS AND KNOWLEDGE

• Demonstrates competence on SAP and the application thereof
• Clinical knowledge in respect of emergency medical services and the application of the Clinical Practice Guidelines
• Relevant aspects of applicable statutory acts / regulations (e.g. Medical Schemes Act, PMB’s, HCPSA Guidelines, POPIA, etc.)
• Demonstrates solid knowledge of rules and regulations regarding funder contracts, and the application thereof e.g. the application of authorisations and motivations for level of care
• Application of clinical codes in the EMS environment
• Demonstrates solid knowledge of anatomy and physiology and terminology
• Demonstrates solid knowledge of, and consistently acts according to Patient Administration policies and procedures
• Data Analysis
• Computer literacy (e.g. Outlook and intranet applications)

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.

Please note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profile

Become a part of our Talent Community and we will get in touch with you as soon as there is a relevant opening that fits your skills, interests and experience.