Melomed Private Hospital is looking for qualified candidates to apply for the position of Confirmations Clerk (Reference: MB-Con-Clerk). If you have at least 3 years of experience in a hospital setting and strong administrative skills, this could be an exciting opportunity for you. Interested applicants should act quickly as vacancies are limited.
What You Will Do as a Confirmations Clerk
Your main role will be to manage authorizations and confirmations related to patient admissions and billing. This includes:
- Getting authorizations for after-hours admissions.
- Recording daily clinical info like Authorization Numbers, Length of Stay (LOS), and Level of Care (LOC).
- Monitoring confirmation reports every day.
- Validating authorizations, memberships, and benefits.
- Confirming membership details and limits on the theatre schedule; sharing info promptly with all stakeholders.
- Following up to register babies as dependents within 7 working days after admission.
- Communicating funder responses and requirements clearly and on time.
- Acting as a link between Case Managers, Medical Funders, and other groups.
- Sending supporting documents (X-rays, MRI scans, pathology reports, letters of motivation, caesarian forms) to funders.
- Following up quickly on unapproved authorizations to meet deadlines.
- Alerting stakeholders on financial risks, such as declined authorizations or benefit limits.
- Communicating with patients about declined authorizations, co-payments, or benefit restrictions.
- Escalating cases that miss approval deadlines to ensure accurate final billing.
- Working with external providers to get outstanding documents needed for billing.
- Resolving queries to maintain performance targets.
- Applying clinical knowledge when reviewing patient account codes (ICD and CPT).
- Performing any other administrative duties as assigned by your manager.
Requirements Needed to Apply
To qualify for this role, you must meet the following:
- Education: Grade 12 or an equivalent NQF4 qualification is required. A certificate in ICD 10 and CPT Coding is preferred.
- Experience: At least 3 years of relevant work experience in a multidisciplinary hospital. Experience with National Hospitals Network (NHN) billing is a plus.
- Skills: Strong computer and administration skills, knowledge of reimbursement models, and a good understanding of laws like Consumer Protection Act, PMB, and POPIA.
- Excellent written and spoken communication skills.
- Ability to meet deadlines and maintain relationships both inside and outside the hospital.
- Willingness to keep up-to-date with industry trends and comply with Melomed’s policies.
Job Details at a Glance
- Position Level: Junior
- Job Type: Permanent
- Salary: Market related
- Employment Equity: No
If you believe you fit the role and want to work in a respected hospital environment, Melomed Private Hospital encourages you to apply. This job offers an excellent chance to build your career in healthcare administration while helping ensure patients get the care and approvals they need on time.
