Confirmations Clerk
Clinix Health Group (Pty) Ltd
Other, Gauteng
Administrative and clerical roles handle the day-to-day paperwork, scheduling and record-keeping that keep SA businesses running, and are a popular path for matriculants with strong organisation skills.
This listing does not state a salary. As a guide, admin roles in South Africa typically pay R8 000 to R20 000 a month (indicative).
Job description
Job Title: Confirmations clerk
Reports to: Patient Services Manager
JOB SUMMARY
To ensure the authorisation and re-authorisation of hospital cases by effectively communicating with the relevant parties, thus minimising financial risk to the business.
REQUIREMENTS
Minimum Qualification:
- Relevant NQF 5 qualification (Clinical)
Added Advantage:
- Related Post Matric Qualification (i.e coding)
Minimum Experience:
- 1-2 years’ experience within a Medical Scheme / private hospital environment
- Demonstrable experience working with patients, doctors and medical schemes
- Working experience of SAP or similar platform
Key Competencies:
- Hospital Operations
- Medical Schemes standards and processes
- Confirmations and Authorisations
- Working knowledge of ICD codes
- Computer literacy
DELIVERABLES**:**
- Obtain authorisation and re-authorisation daily for all identified Medical Scheme patients
- Obtain authorisation within 8 hours for all unplanned Medical Scheme patients
- Obtain authorisation on the first Monday following an admission of an Emergency Unit patient over a weekend
- Capture data, accurately and timeously, and communicate to all parties
- Comply with ICD-10 and CPT-code books
- Escalate to Senior Case Manager for resolution with patient where authorizations remain pending
- Liaise with patients (and family members) regarding suspended, pending and declined authorizations, and ensure that the Case Manager is informed
- Communicate with Doctors regarding certain codes, for example, exclusion codes to ensure that Doctor is informed of decline by medical scheme
- Liaise with Mothers (or guarantors) regarding the completion of the registration forms for new-born babies with the Medical Scheme/s and follow up to ensure registration has been completed by the Medical Scheme
- Develop relationships with Doctors to ensure they are kept up to date with any issues with medical aids schemes
Good to know
What does this admin job pay?
This listing does not state a salary. As a guide, admin roles in South Africa typically pay R8 000 to R20 000 a month (indicative).
Do I need experience for admin jobs in Other?
This admin role may ask for some experience or a relevant qualification. Read the listing for the specifics before you apply.
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Found on Indeed · Posted Yesterday