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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 rules.Capture relevant data and communicate to the necessary parties.Obtain all required supporting documentation in order to support the authorisation process.Identify and refer high-risk cases to minimise financial risks.Adhere to clinical coding protocols.Ensure compliance to the confirmation procedures and funder contracts by utilising available resources and systems.REQUIRED EDUCATIONESSENTIAL EDUCATION: Grade 12 or equivalent.
DESIRED EDUCATION: None.
REQUIRED EXPERIENCEEssential 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 Funders.Rules relating to Funder Contracts.Clinical coding (i.e.
understanding and application of ICD10 rules).Management of PMB (prescribed minimum benefit) cases.Relevant 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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