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Mediclinic wants to alert candidates that third parties are from time to time fraudulently advertising vacancies at Mediclinic and / or offering employment contracts with subsequent payment instructions to accounts linked to the fraudulent activity. Please note that Mediclinic will never request payment for an application or offer made. All official vacancies are advertised on the Mediclinic career website and candidates are advised to visit the site to confirm the validity of vacancies.
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Closing date: 28/06/2024
Number of positions: 1
Recruiter name: Wendy Van Rensburg
Reference number: 51737
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 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
DESIRED EDUCATION: None REQUIRED EXPERIENCE DESIRED 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 trouble,shooting)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.
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Become a part of our Talent Community and we will get in touch with you as soon as there is a relevant opening that fits your skills, interests and experience.
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