Confirmations Clerk

South Africa, South Africa

Job Description


Mediclinic Legae | Mabopane, Pretoria | South Africa

Closing date: 18/03/2024
Number of positions: 1
Recruiter name: Kelebogile Rennie Letsholo
Reference number: 48390
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

Essential minimum experience: None

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.)
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

Join our Talent Community

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.

Job Type: Administration

Video Token: eF4n-VsAniU

Custom Field 1: v1667564201/9768_mobile_1537X400_1_khdpud.jpg

Mediclinic

Beware of fraud agents! do not pay money to get a job

MNCJobs.co.za will not be responsible for any payment made to a third-party. All Terms of Use are applicable.


Job Detail

  • Job Id
    JD1298933
  • Industry
    Not mentioned
  • Total Positions
    1
  • Job Type:
    Full Time
  • Salary:
    Not mentioned
  • Employment Status
    Permanent
  • Job Location
    South Africa, South Africa
  • Education
    Not mentioned