Confirmations Clerk

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Mediclinic Milnerton Milnerton, Cape Town South Africa

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

To minimise financial risk by ensuring authorisation and re-authorisation of all cases through effective communication between relevant parties.

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

ESSENTIAL EDUCATION: Grade 12 or equivalent

DESIRED EDUCATION: None

DESIRED EXPERIENCE : Experience in Clinical Environment

• 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)
• 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.