About this role
<p><b>Mediclinic Heart Hospital | Arcadia, Pretoria | South Africa </b></p> <p><br> Closing date: 03/07/2026 <br> Number of positions: 1 <br> Recruiter name: Dumile Khethiwe Magagula <br> Reference number: 71542 <br> <span id="cke_bm_1564S" style="display:none"> </span>Workplace Type: On-site<br> Permanent</p> <p><em><b><span style="font-size:10.0pt"><span>Please note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profile</span></span></b></em></p> <div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px"><b>MAIN PURPOSE OF JOB</b></H2> </div><div><p><span style="font-size:10.0pt"><span style="font-family:'Arial', 'sans-serif'"><span style="color:#555146">To minimise financial risk by ensuring authorisation and re-authorisation of all cases through effective communication between relevant parties.</span></span></span></p> </div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px"><b>KEY RESPONSIBILITY AREAS</b></H2> </div><div><p><span style="font-size:10.0pt"><span style="font-family:'Arial', 'sans-serif'"><span style="color:#555146">Obtain authorisation and re-authorisation for all identified patients to ensure fully paid claims</span></span></span></p> <p><span style="font-size:10.0pt"><span style="font-family:'Arial', 'sans-serif'"><span style="color:#555146">Capture data and communicate to all parties</span></span></span></p> <p><span style="font-size:10.0pt"><span style="font-family:'Arial', 'sans-serif'"><span style="color:#555146">Identify and refer risk cases to minimise financial risks</span></span></span></p> <p><span style="font-size:10.0pt"><span style="font-family:'Arial', 'sans-serif'"><span style="color:#555146">Adhere to clinical coding standards as per Level 2 coding guideline</span></span></span></p> <p><span style="font-size:10.0pt"><span style="font-family:'Arial', 'sans-serif'"><span style="color:#555146">Ensure compliance to the confirmation procedure contracts and legal aspects by utilising available resources and systems </span></span></span></p> </div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px"><b>REQUIRED EDUCATION</b></H2> </div><div><p><strong><span style="font-size:10.0pt"><span style="font-family:'Arial Black', 'sans-serif'"><span style="color:#555146">ESSENTIAL EDUCATION: </span></span></span></strong><span style="font-size:10.0pt"><span style="font-family:'Arial', 'sans-serif'"><span style="color:#555146"> Grade 12 or equivalent</span></span></span></p> <p><strong><span style="font-size:10.0pt"><span style="font-family:'Arial Black', 'sans-serif'"><span style="color:#555146">DESIRED EDUCATION: None </span></span></span></strong></p> </div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px"><b>REQUIRED EXPERIENCE</b></H2> </div><div><p>Essential minimum experience: None</p> <p><strong><span style="font-size:10.0pt"><span style="font-family:'Arial Black', 'sans-serif'"><span style="color:#555146">DESIRED EXPERIENCE</span></span></span></strong><span style="font-size:10.0pt"><span style="font-family:'Arial', 'sans-serif'"><span style="color:#555146">: Experience in Clinical Environment </span></span></span></p> </div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><H2 style="font-size:1.0em;margin:0.0px"><b>REQUIRED JOB SKILLS AND KNOWLEDGE</b></H2> </div><ul style="margin-top:0.0;margin-bottom:0.0"><li>Funder Contracts; Medical aid requirements/narrations </li><li>Patient admin programmes on the AS400 system </li><li>Rules and regulations regarding funder contracts </li><li>Clinical coding (Level 2 coding) </li><li>B2B EMS (electronic message system: check status of authorisations and use for trouble,shooting) </li><li>Computer literate (Microsoft Office) </li><li>Relevant aspects of applicable statutory acts (e.g. Consumer Protection Act; PMB; etc.) </li><li>Patient Administration policies and procedures (e.g. Patient Confidentiality; Visitation of external case managers; etc.) </li><li>Daily workflow; managing deviances; coding; and case management processes </li><li>Identify possible financial risks (e.g. no authorisation; insufficient LOS or LOC; etc.) </li></ul></div></div><p>All applicants will be considered, with the understanding that preference will be given in accordance with the Employment Equity Plan of Mediclinic Southern Africa, as well as internal applicants/employees that meet the minimum requirements.</p> <p><em><b><span style="font-size:10.0pt"><span>Please note if you are an internal employee on a fixed term contract please apply using an external candidate profile and not your employee profile</span></span></b></em></p> <p> </p>