Confirmations Clerk

Mediclinic Legae | Mabopane, Pretoria | South Africa
Closing date: 06/10/2024
Number of positions: 1
Recruiter name: Kelebogile Rennie Letsholo
Reference number: 54582
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 JOBTo minimise financial risk by ensuring authorisation and re-authorisation of all cases through effective communication between relevant parties.
KEY RESPONSIBILITY AREASObtain 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 EDUCATIONESSENTIAL EDUCATION: Grade 12 or equivalent
DESIRED EDUCATION: None
REQUIRED EXPERIENCEDESIRED EXPERIENCE: Experience in Clinical Environment
REQUIRED JOB SKILLS AND KNOWLEDGEFunder Contracts; Medical aid requirements/narrationsPatient admin programmes on the AS400 systemRules and regulations regarding funder contractsClinical coding (Level 2 coding)B2B EMS (electronic message system: check status of authorisations and use for troubleshooting)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 processesIdentify 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

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