Confirmations Clerk

Medi Clinic; Cape Town; On-site; ZAR 25 000 - 45 000; Full time

Job summary

An established industry player is seeking a dedicated professional to minimize financial risks through effective communication and management of patient authorizations. This role involves ensuring compliance with clinical coding standards and managing workflows in a clinical environment. The ideal candidate will have a strong foundation in patient administration and relevant statutory acts, contributing to the smooth operation of healthcare services. Join a team committed to excellence in patient care and administrative efficiency, where your skills will directly impact the quality of service provided to patients.

Qualifications

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

Responsibilities

• Obtain authorisation for patients to ensure fully paid claims.
• Capture data and communicate effectively with all parties.

Skills

Funder Contracts

Patient admin programmes on the AS400 system

Clinical coding (Level 2 coding)

Computer literate (Microsoft Office)

B2B EMS

Education

Grade 12 or equivalent

Tools

AS400 system

Microsoft Office

Job description

Mediclinic Louis Leipoldt| Bellville, Cape Town | South Africa

Closing date: 13/05/2025
Number of positions: 1
Recruiter name: Nadia Botha
Reference number: 57542
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