Job Description: The incumbent will be responsible, in collaboration with Hospital Clinical Coder and hospital case management teams, for liaising between the patients, treating clinicians, and managed care organisations in order to provide clinical coding that is updated in accordance with the patient response to treatment in order to receive reimbursement from funders. This will include escalations to relevant management at Administrators or Funders for resolution where necessary. Job Responsibilities: Communicate with funders about clinical coding errors and disputes. Identifies discrepancies, potential quality of care and billing issues. Review of PMB queries and recommendations for action. Analysis of medical records and identifies documentation deficiencies. Utilize all available digital resources for accurate and appropriate clinical coding. Monitor compliance with group policies, procedures and processes via CSA process Actions are guided by the South African Code of Ethics for Clinical Coders and South African coding standards. Conduct audits and clinical coding reviews to ensure all documentation is accurate and precise. Comply with all legal requirements regarding clinical coding procedures and practices. Review clinical coding periodically during a patient event in relation to mapped coding requirements. Job Requirements: Minimum of 5 years’ experience in Clinical Coding and or Case management in a hospital environment Multi-disciplinary clinical experience. Medical terminology. Intermediate computer proficiency. Attention to detail. Analytical skills. Qualification & Experience: SANC registration as a Registered Nurse. Diploma in Nursing or equivalent NQF level 6 within healthcare sciences. Certificate in Advanced ICD-10. Certificate in Advanced Complete CPT for South Africa (CCSA). CPC (AAPC) or CCO (AHIMA) Job Details: Company: Netcare Vacancy Type: Full Time Job Location: Johannesburg, Gauteng, SA Application Deadline: N/A Apply Here Vacancieshut.com
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