Clinical Coding Specialist

Discovery Limited; Gauteng; On-site; ZAR 60 000 - 100 000; Full time

Job summary

An established industry player is looking for a Clinical Coding expert to lead initiatives that enhance healthcare data quality. This role involves ensuring compliance with coding standards, driving innovations in clinical coding, and maintaining the reputation of a Clinical Coding Centre of Excellence. The ideal candidate will have extensive experience in health insurance and clinical coding, with a strong focus on strategic thinking and stakeholder management. Join a dynamic team committed to making a meaningful impact in healthcare through high-quality data and coding excellence.

Qualifications

• 10+ years of experience in clinical coding and health insurance.
• Bachelor's degree in a medical field is essential.

Responsibilities

• Ensure regulatory compliance with coding standards across regions.
• Collect high-quality clinical data for analytics and risk management.

Skills

Clinical Coding expertise

Analytical skills

Project management

Negotiation skills

MS Office proficiency

Excellent written and verbal communication

Presentation skills

Stakeholder Management

Education

Bachelor's degree in a medical field

Qualification in Health Informatics

International coding accreditation (CPC or CCS)

Job description

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 to not only achieve financial success but also 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 where clinical data (diagnoses, procedures/interventions, pharmaceuticals, etc.) is represented in standardised coded terminology.

This skillset is globally rare, requiring multiple years of experience and exposure to international standards, principles, and world-class terminology organizations.

The role focuses on identifying efficiencies and extracting intelligence from the most valuable currency in modern healthcare: high-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.

Responsibilities include:

1. Ensuring regulatory compliance with industry coding standards across regions.
2. Using appropriate coding schemas (per national and international guidelines) to collect high-quality clinical data for benefits, disease profiling, analytics, and risk management tools.
3. Facilitating effective systems and operational processes within and outside the organization.
4. Upskilling within the Group to ensure business continuity and drive coding innovations.
5. Building and maintaining Discovery/Vitality Group's reputation as a Clinical Coding Centre of Excellence.
6. Partnering with international institutions to stay updated on coding initiatives.
7. Representing the Coding Intelligence team internally and externally.
8. Contributing to strategic decisions related to Clinical Coding to support business objectives.

Personal Attributes and Skills

• Values Driven
• Learns on the Fly
• Resilient
• Trustworthy
• People Savvy
• Results-Oriented
• Strategic Thinker
• Stakeholder Management

Technical Skills and Knowledge

• Excellent written and verbal communication
• Presentation skills
• Analytical skills
• Project management
• Negotiation skills
• MS Office proficiency
• Clinical Coding expertise in international classifications and terminologies

Education and Experience

• Bachelor's degree in a medical field (e.g., Nursing, Physiotherapy, Clinical Technology) is essential.
• Additional qualification in Health Informatics (advantageous).
• International coding accreditation such as CPC (AAPC) or CCS (AHIMA) (advantageous).
• At least 10 years of relevant work experience.
• Strategic experience in a clinical coding environment, especially in health insurance.

We are committed to employment equity and encourage applicants with disabilities to apply.