Choose how often (in days) you want to receive a notification: Mediclinic Medforum | Sunnyside, Pretoria | South Africa Closing date: 27/09/2024 Number of positions: 1 Recruiter name: Mokgadi Florah Hlungwani Reference number: 54244 Workplace Type: On-site Permanent 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 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 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. #J-18808-Ljbffr