Mediclinic Cape Town | Cape Town | South AfricaClosing date: 10/01/2025Number of positions: 1Recruiter name: Helena PadayacheeReference number: 56559Workplace Type: On-sitePermanentPlease 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 JOBTo minimise financial risk by ensuring authorisation and re-authorisation of all cases through effective communication between relevant parties.KEY RESPONSIBILITY AREASObtain 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 EDUCATIONESSENTIAL EDUCATION: Grade 12 or equivalent.DESIRED EDUCATION: None.REQUIRED EXPERIENCEDESIRED EXPERIENCE: Experience in Clinical Environment.REQUIRED JOB SKILLS AND KNOWLEDGEFunder 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 troubleshooting).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.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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