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Case Administrator
Location: Mediclinic Hoogland, Bethlehem, South Africa
Closing Date: 11 February 2025
Reference Number: 57459
Workplace Type: On-site
Job Type: Permanent
Job Purpose
To reduce financial risk by ensuring the authorisation and re-authorisation of all cases through effective communication with relevant parties.
Key Responsibilities
- Obtain authorisation and re-authorisation for identified patients to ensure fully paid claims.
- Capture data and communicate information to all relevant parties.
- Identify and refer risk cases to minimise financial exposure.
- Adhere to clinical coding standards as per Level 2 coding guidelines.
- Ensure compliance with confirmation procedures, contracts, and legal requirements by using available resources and systems.
Minimum Requirements
Education:
- Grade 12 (Matric) or equivalent.
Experience:
- No prior experience required.
- Experience in a clinical environment (preferred).
Skills and Knowledge
- Understanding of funder contracts and medical aid requirements.
- Knowledge of patient administration programmes (AS400 system).
- Clinical coding (Level 2).
- Familiarity with B2B EMS (electronic message system).
- Proficiency in Microsoft Office.
- Knowledge of statutory acts (e.g., Consumer Protection Act, PMB).
- Understanding of patient administration policies and confidentiality.
- Ability to identify financial risks (e.g., lack of authorisation, insufficient LOS/LOC).
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