Confirmations Clerk

Medi Clinic; Sandton; On-site; ZAR 30 000 - 50 000; Full time

Job summary

An established industry player in healthcare is seeking a detail-oriented professional to join their team. This role focuses on minimising financial risks by ensuring the authorisation of patient claims through effective communication. The ideal candidate will have a strong understanding of clinical coding and patient administration, along with the ability to manage workflows and identify potential financial risks. If you are passionate about making a difference in patient care and have the necessary skills, this opportunity could be the perfect fit for you.

Qualifications

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

Responsibilities

• Obtain authorisation for patients to ensure fully paid claims.
• Capture data and communicate to all relevant parties.
• Identify and refer risk cases to minimise financial risks.

Skills

Funder Contracts

Clinical coding (Level 2 coding)

Patient admin programmes on the AS400 system

B2B EMS

Patient Administration policies and procedures

Education

Grade 12 or equivalent

Job description

Mediclinic Sandton | Bryanston, Johannesburg | South Africa

Closing date: 11/05/2025
Number of positions: 1
Recruiter name: Nomsa Rachel Somzila
Reference number: 60158
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

About the company

Mediclinic International plc, founded in 1983, is an international private hospital group with operations in South Africa, Namibia, Switzerland and the United Arab Emirates.