Confirmations Clerk

Medi Clinic; Durban; On-site; ZAR 50,000 - 200,000; Full time

Job summary

A leading healthcare provider in Durban seeks a candidate to manage patient authorizations and minimize financial risks. Responsibilities include capturing data and ensuring compliance with coding standards. Ideal for candidates with a Grade 12 education and some experience in a clinical environment. Preference will be given to applicants in accordance with the Employment Equity Plan.

Qualifications

• Grade 12 or equivalent is essential.
• Experience in a clinical environment is desired.

Responsibilities

• Obtain authorization for patients to ensure paid claims.
• Capture data and communicate to relevant parties.
• Identify and refer risk cases.

Skills

Funder Contracts

Patient admin programmes

Clinical coding (Level 2)

Computer literacy (Microsoft Office)

Knowledge of statutory acts

Education

Grade 12 or equivalent

Tools

AS400 system

Job description

Mediclinic Durbanville| Durbanville, Cape Town | South Africa

Closing date: 22/07/2025
Number of positions: 1
Recruiter name: Monique Joy Hector
Reference number: 62208
Workplace Type:On-site
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 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

Essential minimum experience: None

DESIRED EXPERIENCE : Experience in Clinical Environment

REQUIRED JOB SKILLS AND KNOWLEDGE

• Funder Contracts; Medical aid requirements/narrations
• Patient admin programmes on the AS400 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)
• Computer literate (Microsoft Office)
• 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