Main Purpose of Job:

The Confirmations Clerk plays a crucial role in minimizing financial risk by ensuring the authorization and re-authorization of all cases. This position requires effective communication with relevant parties to facilitate fully paid claims.

Key Responsibility Areas:

• Obtain authorization and re-authorization for all identified patients to ensure claims are fully paid.
• Capture data accurately and communicate with all relevant parties.
• Identify and refer risk cases to minimize financial risks.
• Adhere to clinical coding standards as per Level 2 coding guidelines.
• Ensure compliance with confirmation procedures, contracts, and legal aspects using available resources and systems.

Required Education:

• Essential: Grade 12 or equivalent.
• Desired: None.

Required Experience:

• Essential: 2-3 years of relevant experience.
• Desired: Experience in a clinical environment.

Required Job Skills and Knowledge:

• Understanding of funder contracts and medical aid requirements.
• Proficiency in patient administration programs, specifically the AS400 system.
• Knowledge of rules and regulations regarding funder contracts.
• Familiarity with clinical coding (Level 2 coding).
• Experience with B2B EMS for checking authorization statuses and troubleshooting.
• Computer literacy, particularly in Microsoft Office.
• Awareness of applicable statutory acts (e.g., Consumer Protection Act, PMB).
• Knowledge of patient administration policies and procedures, including patient confidentiality and visitation protocols.
• Ability to manage daily workflow, coding, and case management processes.
• Skills to identify possible financial risks, such as lack of authorization or insufficient length of stay (LOS) or level of care (LOC).

Additional Information:

All applicants will be considered, with preference given according to the Employment Equity Plan of Mediclinic Southern Africa, as well as internal applicants who meet the minimum requirements. Note: Internal employees on a fixed-term contract should apply using an external candidate profile.

How to Apply:

Interested candidates should submit their applications through the Mediclinic careers website by the closing date. Ensure all required documents are included to facilitate the application process. Join us at Wits Donald Gordon Med Centre and contribute to our mission of providing exceptional healthcare while minimizing financial risk!