Receive admission details from admission clerks.
Ensure that all Authorisations are received and confirmed with the relevant funder for patients being admitted to our hospital
Confirmations must be received the same day as admission with the possible exception of weekend admissions, which must be given the highest priority on Monday morning or the day after a public holiday
Where confirmations are delayed, strict and regular follow up must be maintained to ensure that the hospital does not suffer losses in the case of fraudulent admissions
Notify relevant departments and patients of any irregularities regarding the patients authorisation e.g. declined status, suspended status etc.
Ensure level of care (LOC) and length of stay (LOS) obtained and re-authorisations received from the fund are updated on SAP system.
Obtain and submit letter of motivation (LOM) or a treatment plan to funders
Ensure all necessary documentation is faxed, emailed to funders as necessary e.g. Injury reports, PMA reports
Refer any queries or problems immediately to the Manager, particularly in the case of delays and where a short stay is expected
Liaise with Case Manager in the event of a Managed Care patient being admitted (e.g. identified by the medical aid name) handing over patient details for internal case management follow up
File all written confirmations in the patients file
Enter all confirmation details into the computer system
Maintain a schedule of all confirmations and in particular those outstanding and advise
Patient Administration Manager/Credit Manager on a daily basis so that priorities can be set for follow up
Maintain a professional and sound relationship with contact persons at medical
aids/managed care organisations
To assist with other duties in the Patient Administration or Credit Department as maybe requested from time to time and within the scope of knowledge and expertise of the incumbent

3.2 KEY PERFORMANCE AREA 2: CONTINUOUS QUALITY IMPROVEMENT (CQI)

Constantly be aware of work process problems or bottlenecks that prevent the achievement of goals, objectives and targets
Take appropriate action in improving any process that will allow the reduction of cost and/or improvement to quality, service and productivity

4. KEY OUTPUTS

Consistently achieve agreed standards of timeous receipt of confirmations
Building of sound relationships with medical aids contact persons
Building of sound relationships with doctors’ rooms receptionists
Building of sound relationships with admission and credit department staff
Building of sound relationships with all other hospital departments with the highest cooperation levels
Develop and maintain a sound working relationship with your manager

5. INHERENT REQUIREMENTS OF THE POSITION

Must have at least 2 years of confirmations experience
Knowledge of funders and private healthcare industry

6. MINIMUM QUALIFICATION

Grade 12 (Matric)
A nursing qualification (an advantage)

7. COMPETENCIES REQUIRED

Ability to engage various stakeholders and must be able to deliver exceptional customer service.
Computer literate, accurate, stringent attention to details

8. PERSONAL CHARACTERISTICS

Organised and able to work well under pressure
Displays initiative and able to work independently
Customer-orientated with good interpersonal and communication skills including excellent telephone skills

Job Type: Full-time

Ability to commute/relocate:

Abaqulusi, KwaZulu-Natal: Reliably commute or planning to relocate before starting work (Required)

Work Location: In person

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