Confirmations Clerk

Mediclinic International; Randburg; On-site; ZAR 300,000 - 450,000; Full time

Job summary

Mediclinic International is seeking an Authorisation Officer to minimize financial risks by managing patient authorizations and ensuring compliance with clinical coding standards. This permanent, on-site position in Randburg requires a Grade 12 qualification and experience in a clinical environment. The role focuses on accurate data handling and risk identification through effective communication.

Qualifications

• Grade 12 or equivalent is essential.
• Desired experience in a clinical environment.

Responsibilities

• Obtain authorisation and re-authorisation for patients.
• Ensure compliance with coding standards and financial risk minimization.
• Communicate data to relevant parties for claims.

Skills

Funder Contracts

Medical aid requirements/narrations

Clinical coding

Patient admin programmes

Relevant statutory acts

Education

Grade 12 or equivalent

Job description

Mediclinic Sandton| Bryanston, Johannesburg | South Africa

Closing date: 29/06/2025
Number of positions: 1
Recruiter name: Nomsa Rachel Somzila
Reference number: 61585
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

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)
• 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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