Medical Admin Clerk

SUMMARY:
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POSITION INFO:

Job Summary:

• Obtain timeous and accurate authorization from medical aid so patient can start treatment as soon as possible.
• Billing of medical aids and patients for Hospital/ Rooms consultations and treatment received.
• Follow up of all rejected medical aid and patient accounts.
• Responsible for the collection of payments made by patient and issue a receipt. Controlling of practice age analysis and keeping it to a minimum.

Minimum Requirements:

· Matric

· 2 Years in billing (ideally Vericlaim)

Key Requirements

Authorisation Process:

• To register patients on the oncology program.
• To complete and send the completed SAOC forms to the medical aid
• Must follow up on the outstanding Authorisations
• Check received authorisation prior to start of treatment
• Do date extensions
• Load all documents on the EMR system.
• Responsible for re-auths or/and adjustments
• Upkeep of stats
• Upkeep of registers

Expected Results:

• Prompt and accurate process
• Minimal delays for excellent private patient care
• Availability of recorded documents when needed as proof
• Smooth workflow

Billing Process:

• Registration of PMB conditions with Medical Aid
• Bill patients for treatment received and consultations
• Billing insurance forms completed by doctors
• Action rejected billing codes and follow up with medical aids
• Work through practice age analysis and follow up on outstanding fees

Patient care and rendering of a quality service:

• Assist with telephonic queries
• Feedback to doctors and management team regarding auth process
• Laisse with stakeholders including hospital regarding booking patients for treatment.
• Hands-on problem
• Solving and assistance with any queries
• Smooth patient experience

 

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