Mediclinic Confirmations Clerk Jobs in South Africa

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

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).

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.)

How to Apply

For more information and job application details, see; Mediclinic Confirmations Clerk Jobs in South Africa

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