Billing Operations Cluster BOC Confirmations Clerk

• We provide meaningful careers that connect people with purpose.
• We are united by a common purpose of providing the best and safest care; and by our shared values of Care, Truth, Participation, Compassion and Dignity.
• Netcare invites you to be part of our journey.

ROLE SUMMARY

The confirmations clerk communicates with funders and internal managed healthcare teams regarding confirmations of authorisations and available benefits. The incumbent will be responsible for confirming authorisations, length of stay, clinical codes and level of care for patients.

KEY WORK OUTPUT AND ACCOUNTABILITIES

OPERATIONAL EXCELLENCE

Confirmations process

• Manage that all medical aid patients have the necessary authorisation for hospital admission.
• Systematic follow-up of all outstanding authorisations.
• Ensure all relevant information received from the insurance provider is accurately reflected on the SAP system.
• Control of incomplete, inaccurate and delayed confirmation data as these have ramifications for accurate reporting of billing financials.
• Working within day end parameters to ensure that there is flow of files from case management to final billing.
• Manage and escalate outstanding funder responses.
• Secure requested letter of motivations from doctors when applicable.
• Collaborate with the Hospital Billing Coordinator on following up outstanding hospital documentation.

Communication

• Maintain Netcare digital system of communications strictly.
• Be courteous and professional in all interactions with funders and other stakeholders.

General

• Assist with any adhoc duties assigned by the BOC Case Manager/ Billings Manager.
• Work collaboratively alongside case managers, file assessors and coders for effective task resolution.
• Be agile in approach as Netcare moves to digitally enabled systems.

GROWING WITH PASSIONATE PEOPLE

Personal and professional development

• Assume responsibility for own personal and professional development.
• Keep up to date with Netcare’s evolving policies and procedures.
• Maintain and sustain effective working relationships with all customers and colleagues.

BEST AND SAFEST PRACTICE

POPIA

• Always maintain patient confidentiality. SKILLS PROFILE

EDUCATION

Required

• Grade 12 or equivalent NQF Level 4 Qualification.

WORK EXPERIENCE

Required

• Experience in a healthcare setting.
• Experience with any clinical or healthcare related billing systems.

KNOWLEDGE

Required

• Computer literacy

PHYSICAL REQUIREMENTS

In the event of any physical or psychological limitation that may impair the employee’s ability to perform the required job function, the employee must consult the employer for reasonable accommodation.

VALUES AND BEHAVIOURS

Netcare Values

At Netcare, our core value is care. We care about the dignity of our patients and all members of the Netcare family. We care about the participation of our people and our partners in everything we do. We care about truth in all our actions. We are passionate about quality care and professional excellence.

• Care - The basis of our business. The professional, ethical patient care and services we offer at every level of the organisation.
• Truth - The crucial element in building relationships that work. Open communication with honesty and integrity is essential.
• Dignity - An acknowledgement of the uniqueness of individuals. A commitment to care with the qualities of respect and understanding.
• Compassion - The creative, compassionate and innovative drive to do things better than before. To develop and implement successful healthcare solutions for all.
• Participation - The willingness and desire to work in productive and creative partnerships with others and the commitment to communicate.

The Netcare Way

Netcare is committed to providing quality care. Our basic service standard holds us accountable for the below five behaviours which you will be accountable to uphold:

• I always greet everyone to show my respect.
• I always wear my name badge to show my identity.
• I always treat others with consideration and humility to uphold dignity
• I always act in the best interest of Netcare and others to show I care.
• I always listen with empathy and respond with kind action to show my compassion
• I always say thank you to show my appreciation.
• I always embrace diversity to show I am not a racist.

SKILLS

Customer Focus and Service Delivery

The capacity to identify and respond to the needs of *internal and external customers.

Personal Work Ethic

Capacity to instil an ethic of quality and consistency in self and others.

Building Relationships

Capacity to establish constructive and effective relationships.

Communication

The capacity to clearly present information, either written or verbal.

Teamwork

Capacity to cooperate with others to work towards a common goal.

Technical Knowledge

The capacity to perform a technical function to required standards.

WORKING CONDITIONS

• Professional flexibility in working hours while supporting daily business operations which may include weekends and night shifts where applicable.
• Will interact with internal and external customers through several different means.

Join the team committed to providing the best and safest health and care.