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Mediclinic Southern Africa Corporate Office | Pretoria | South Africa
Closing date: 07/01/2025
Number of positions: 1
Recruiter name: Fiona Simone Anderson
Reference number: 56597
Workplace Type: Permanent
MAIN PURPOSE OF JOBTo minimise financial risk by ensuring timeous and accurate 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 that claims are fully paid, or paid in accordance with the funder's benefit rulesCapture relevant data and communicate to the necessary partiesObtain all required supporting documentation in order to support the authorisation processIdentify and refer high risk cases to minimise financial risksAdhere to clinical coding protocolsEnsure compliance to the confirmation procedures and funder contracts by utilising available resources and systemsREQUIRED EDUCATIONESSENTIAL EDUCATION: Grade 12 or equivalent
DESIRED EDUCATION: None REQUIRED EXPERIENCEREQUIRED EXPERIENCE: Essential minimum experience: 1-2 years in a practice management/patient administration environment
DESIRED EXPERIENCE: Experience as a Confirmations Clerk/Authorisations Clerk, Billings Clerk, or Receptionist in the healthcare industry
REQUIRED JOB SKILLS AND KNOWLEDGEUtilising relevant systems to obtain authorisations from FundersRules relating to Funder ContractsClinical coding (i.e.
understanding and application of ICD10 rules)Management of PMB (prescribed minimum benefit) casesRelevant aspects of applicable statutory acts (e.g.
Medical Schemes Act; etc.
)Patient Administration policies and procedures (e.g.
Patient Confidentiality; etc.
)Computer literate (Microsoft Office, practice management software)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.
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