Confirmations Clerk

Mediclinic International; Cape Town; On-site; ZAR 50 000 - 200 000; Full time

Job summary

A healthcare provider in Cape Town is seeking a candidate to minimize financial risk by ensuring authorisation and re-authorisation of all cases. The ideal candidate will manage communication between parties and adhere to clinical coding standards. Essential qualifications include Grade 12 or equivalent, and experience in a clinical setting is preferred.

Qualifications

• Grade 12 or equivalent is essential.
• Experience in a clinical environment is desirable.
• Knowledge of funder contracts and regulations required.

Responsibilities

• Obtain authorisation and re-authorisation for patients.
• Capture data and communicate to all parties.
• Identify and refer risk cases to minimize financial risks.

Skills

Funder Contracts

Medical aid requirements

Patient administration programmes

Clinical coding (Level 2 coding)

Education

Grade 12 or equivalent

Job description

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Mediclinic Cape Gate| Brackenfell, Cape Town | South Africa

Closing date : 17 / 11 /

Number of positions : 1

Recruiter name : Jamie Levern Scholtz

Workplace Type : On-site

Permanent

MAIN PURPOSE OF JOB

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

REQUIRED EDUCATION

ESSENTIAL EDUCATION :

Grade 12 or equivalent

DESIRED EDUCATION :

None

REQUIRED EXPERIENCE

DESIRED EXPERIENCE :

Experience in Clinical Environment

REQUIRED JOB SKILLS AND KNOWLEDGE

Funder Contracts; Medical aid requirements / narrations

Patient admin programmes on the AS system

Rules and regulations regarding funder contracts

Clinical coding (Level 2 coding)

B2B EMS (electronic message system : check status of authorisations and use for trouble,shooting)

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.

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

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