Overview
Confirmations Clerk Jobs in Stellenbosch, South Africa at Mediclinic Hoogland
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.)
Title: Confirmations Clerk
Company: Mediclinic Hoogland
Location: Stellenbosch, South Africa
Category: Healthcare
