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Hospital jobs in Vaal Triangle, Gauteng

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    • 1-2 years’ experience within a Medical Scheme / private hospital environment.
    • To ensure the authorisation and re-authorisation of hospital cases by effectively…
    • View all Clinix Health Group (Pty) Ltd jobs - Sebokeng jobs - Clerk jobs in Sebokeng, Gauteng
    • Salary Search: Confirmations Clerk salaries
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Job Post Details

Confirmations Clerk - job post

Clinix Health Group (Pty) Ltd
3.8 out of 5 stars
Sebokeng, Gauteng
Permanent
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Job details

Job type

  • Permanent

Location

Sebokeng, Gauteng

Full 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
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