Confirmations Clerk vacancy at Mediclinic
DEADLINE: 07 February 2025
MAIN PURPOSE OF JOB
To minimize financial risk by ensuring authorization and re-authorization 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.)
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