Clinical Confirmations Specialist

Mediclinic International; Worcester; On-site; ZAR 180,000 - 240,000; Full time

Job summary

Mediclinic Southern Africa is seeking a dedicated professional to manage authorisation and re-authorisation for patients, ensuring claims are fully paid. You will capture and relay information across stakeholders and identify risk cases to minimise losses.

Knowledge of clinical coding (Level 2) and funder contracts is essential. The role requires adherence to patient administration policies and compliance with regulatory acts, with on-site work in Worcester.

Qualifications

• Essential education: Grade 12 or equivalent.
• Experience in clinical environment preferred.
• Familiar with funder contracts and medical aid requirements.
• Knowledge of clinical coding Level 2 and patient confidentiality.

Responsibilities

• Obtain authorisation and re-authorisation for patients to ensure fully paid claims.
• Capture data and communicate to all parties.
• Identify and refer risk cases to minimise financial risks.
• Adhere to Level 2 clinical coding standards.
• Ensure compliance with contracts and legal aspects using available resources and systems.

Skills

Funder contracts

Clinical coding

Patient administration

Regulatory compliance

Workflow management

Risk identification

Education

Grade 12

Tools

AS400 system

EMS

Job description

Mediclinic Southern Africa is seeking a dedicated professional to manage authorisation and re-authorisation for patients, ensuring claims are fully paid. You will capture and relay information across stakeholders and identify risk cases to minimise losses.

Knowledge of clinical coding (Level 2) and funder contracts is essential. The role requires adherence to patient administration policies and compliance with regulatory acts, with on-site work in Worcester.