Ophthalmology Medical Authorisation Specialist

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

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.