Confirmations Clerk

 

Position: Financial Risk Minimization Officer
Recruiter Name: Roberto Eiman

Reference Number: 55280
Workplace Type: On-site

Location: Permanent Position
Closing Date: 31 October 2024

Main Purpose

The role focuses on reducing financial risk by obtaining authorizations and re-authorizations for patient cases, ensuring claims are paid in full. The position requires effective communication between relevant parties and adherence to clinical coding standards and contract regulations.

Key Responsibilities

1. Authorizations: Secure authorizations and re-authorizations for identified patients to ensure claim payment.
2. Data Management: Capture data accurately and keep all stakeholders informed.
3. Risk Identification: Identify and refer risk cases to minimize financial exposure.
4. Coding Compliance: Adhere to clinical coding standards per Level 2 guidelines.
5. Compliance: Ensure all confirmations and legal requirements are met using available resources and systems.

Required Education

• Essential: Grade 12 or equivalent
• Desired: None

Required Experience

• Essential: None
• Desired: Experience in a clinical environment

Job Skills and Knowledge

• Familiarity with medical aid requirements and funder contracts
• Knowledge of patient administration programs on AS400
• Understanding of clinical coding (Level 2)
• Proficiency in B2B EMS for authorization checks
• Computer literacy (Microsoft Office)
• Knowledge of relevant statutory acts (e.g., Consumer Protection Act, PMB)
• Familiarity with patient administration policies and daily workflow processes for case management

Additional Notes

Internal employees on fixed-term contracts should apply using an external candidate profile.

CLICK HERE TO APPLY

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