Confirmations Clerk - Accounts

Mediclinic International

Pretoria

On-site

ZAR 180,000 - 240,000

Full time

13 hours ago
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Job summary

Mediclinic Muelmed in Arcadia, Pretoria is hiring to minimise financial risk by ensuring authorisation and re-authorisation of all cases through effective communication between relevant parties. You will obtain authorisation, capture data, and identify risk cases while adhering to clinical coding standards.

The role requires Grade 12 or equivalent, experience in a clinical environment, and knowledge of funder contracts, AS400 systems, and relevant Acts.

Qualifications

  • Funder contracts and 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.).

Responsibilities

  • 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.

Skills

Funder contracts
Medical aid requirements/narrations
AS400 patient admin
Regulations (funders)
Clinical coding (Level 2)
B2B EMS status checks
Statutory acts awareness
Patient confidentiality
Case management processes
Daily workflow management
Financial risk identification

Education

Grade 12 or equivalent

Tools

AS/400 system

Job description

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Mediclinic Muelmed| Arcadia, Pretoria | South Africa

Closing date: 04/10/2026
Number of positions: 1
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 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.

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