Hermanus: Authorisation Clerk posted by AF Consulting

JVR Software; Hermanus; On-site; ZAR 180,000 - 260,000; Full time

Job summary

JVR Software in the Western Cape overberg Hermanus is seeking an Authorisation Clerk for a specialist ophthalmology practice. You will obtain and manage medical aid authorisations for consultations, procedures and surgeries, and verify ICD-10 codes before submission.

The role involves liaising with medical schemes, hospitals and patients, following up on authorisations, and maintaining accurate patient and financial records.

Qualifications

• Grade 12 (Matric) required.
• Experience in specialist medical practice essential.
• Knowledge of ICD-10 and procedure coding advantageous.

Responsibilities

• Obtain and manage medical aid authorisations for consultations, procedures, and surgeries.
• Verify ICD-10 codes, procedure codes, and practice information before submission.
• Follow up on pending, outstanding, and rejected authorisations.
• Maintain up-to-date knowledge of medical aid rules, funding protocols, and authorisation requirements.
• Liaise professionally with medical schemes, hospitals, and patients regarding authorisation queries.
• Ensure authorisations are obtained within the required turnaround times.
• Communicate directly with patients regarding co-payments, shortfalls, and financial responsibilities.
• Follow up on outstanding patient accounts in accordance with practice procedures.
• Assist with debtor management and age analysis.
• Maintain accurate patient and financial records.
• Work closely with the Ophthalmologist, Practice Manager, and reception team to ensure a seamless patient experience.
• Adhoc admin duties.

Skills

Attention to detail

Communication skills

Organisational skills

Professionalism and confidentiality

Education

Grade 12 (Matric)

Tools

Medical practice management software

Job description

Key Responsibilities

• Obtain and manage medical aid authorisations for consultations, procedures, and surgeries.
• Verify ICD-10 codes, procedure codes, and practice information before submission.
• Follow up on pending, outstanding, and rejected authorisations.
• Maintain up-to-date knowledge of medical aid rules, funding protocols, and authorisation requirements.
• Liaise professionally with medical schemes, hospitals, and patients regarding authorisation queries.
• Ensure authorisations are obtained within the required turnaround times.
• Communicate directly with patients regarding co-payments, shortfalls, and financial responsibilities.
• Follow up on outstanding patient accounts in accordance with practice procedures.
• Assist with debtor management and age analysis.
• Maintain accurate patient and financial records.
• Work closely with the Ophthalmologist, Practice Manager, and reception team to ensure a seamless patient experience.
• Grade 12 (Matric).
• Previous experience in a specialist medical practice is essential.
• Previous experience with medical aid authorisations is essential.
• Knowledge of ICD-10 and procedure coding is essential.
• Knowledge of medical billing will be advantageous.
• Experience in creditors and debtor administration will be advantageous.
• Computer literate with experience using medical practice management software.
• Excellent administrative and organisational skills.
• Strong verbal and written communication skills.
• Ability to work accurately under pressure.
• High level of professionalism, integrity, and confidentiality.

Personal Attributes

We are looking for someone who:

• Takes ownership of their work and is accountable for outcomes.
• Can prioritise and manage multiple tasks effectively.
• Demonstrates initiative and follows through on responsibilities.
• Is patient-centred and enjoys working with people.
• Works well as part of a professional team.
• Demonstrates integrity, professionalism, and accountability in all aspects of the role.

Why Join Our Team

• The opportunity to work in a respected specialist ophthalmology practice.
• A supportive and professional working environment.
• The opportunity to work alongside a highly skilled specialist team committed to excellence in patient care.
• Ongoing learning and development opportunities.
• The opportunity to make a meaningful contribution to excellent patient care.

Role: Authorisation Clerk (Specialist Medical Practice)
Location: Western Cape, Overberg, Hermanus
Salary: TBC

Key Responsibilities

• Obtain and manage medical aid authorisations for consultations, procedures, and surgeries.
• Verify ICD-10 codes, procedure codes, and practice information before submission.
• Follow up on pending, outstanding, and rejected authorisations.
• Maintain up-to-date knowledge of medical aid rules, funding protocols, and authorisation requirements.
• Liaise professionally with medical schemes, hospitals, and patients regarding authorisation queries.
• Ensure authorisations are obtained within the required turnaround times.
• Communicate directly with patients regarding co-payments, shortfalls, and financial responsibilities.
• Follow up on outstanding patient accounts in accordance with practice procedures.
• Assist with debtor management and age analysis.
• Maintain accurate patient and financial records.
• Work closely with the Ophthalmologist, Practice Manager, and reception team to ensure a seamless patient experience.
• Adhoc admin duties

Minimum Requirements

• Grade 12 (Matric).
• Previous experience in a specialist medical practice is essential.
• Previous experience with medical aid authorisations is essential.
• Knowledge of ICD-10 and procedure coding is essential.
• Knowledge of medical billing will be advantageous.
• Experience in creditors and debtor administration will be advantageous.
• Computer literate with experience using medical practice management software.
• Excellent administrative and organisational skills.
• Strong verbal and written communication skills.
• Ability to work accurately under pressure.
• High level of professionalism, integrity, and confidentiality.

Personal Attributes

We are looking for someone who:

• Has exceptional attention to detail.
• Takes ownership of their work and is accountable for outcomes.
• Can prioritise and manage multiple tasks effectively.
• Demonstrates initiative and follows through on responsibilities.
• Is patient-centred and enjoys working with people.
• Works well as part of a professional team.
• Demonstrates integrity, professionalism, and accountability in all aspects of the role.

Why Join Our Team

• The opportunity to work in a respected specialist ophthalmology practice.
• A supportive and professional working environment.
• The opportunity to work alongside a highly skilled specialist team committed to excellence in patient care.
• Ongoing learning and development opportunities.
• The opportunity to make a meaningful contribution to excellent patient care.