Job Description

Mediclinic Nelspruit | Sonheuwel, Nelspruit | South AfricaClosing date: 21/06/2024
Number of positions: 2
Recruiter name: Nhlanhla Samaria Mahlangu
Reference number: 51562
Workplace Type: On-site
PermanentPlease note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profileMAIN 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 claimsCapture data and communicate to all partiesIdentify and refer risk cases to minimise financial risksAdhere to clinical coding standards as per Level 2 coding guidelineEnsure compliance to the confirmation procedure contracts and legal aspects by utilising available resources and systemsREQUIRED EDUCATIONESSENTIAL EDUCATION: Grade 12 or equivalentDESIRED EDUCATION: NoneREQUIRED EXPERIENCEEssential minimum experience: NoneDESIRED EXPERIENCE: Experience in Clinical EnvironmentREQUIRED 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.)

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.Please note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profileJoin our Talent CommunityBecome 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.Job Type: AdministrationVideo Token: a6RgOXPyl88Custom Field 1: v1658243237/MCSA_job_advert_header_mbsg7o.jpg

Mediclinic