Confirmations Clerk

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

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.

Closing date: 13/09/2026

Number of positions: 1

On-site

Permanent