Confirmations Clerk – Herolim Private Hospital View All Careers
Description
A vacancy exists for a Confirmations Clerk reporting to the Patient Administrations Manager. The successful candidate will be responsible for securing timeous and accurate authorization for patient admissions and scheduled procedures. This includes verifying patient benefits, confirming scope of cover, identifying potential shortfalls or co-payments, and communicating these with the relevant stakeholders.
Critical Outputs
• Load all authorisations, disclaimers, and approval documents onto PROCLIN or other relevant platforms.
• Ensure daily inbox monitoring and escalation of unresolved queries to Case Management.
• Flag high-risk accounts (e.g., pending authorisations, special equipment, prosthesis) and track until resolved.
• Ensure coding of in-hospital is aligned with authorisation approvals.
• Maintain filing, records, and archiving of all confirmation’s documentation.
• Maintain a live tracking tool/dashboard for rejections, pending approvals, and turnaround metrics.
• Identify recurring bottlenecks in funder responses or clinical handover and raise these via escalation matrix.
• Contribute monthly statistics for departmental reporting on confirmation trends and funder delays.
• Pre-screen admissions for financial clearance and benefit verification at point of scheduling.
• Minimise billing delays and queries through accurate confirmation practices.
Requirements
• Grade 12 / Matric (NQF Level 4)
• Minimum of 2–3 years in a hospital admissions or authorisation- related role.
• Intermediate computer literacy (Word, Excel, PROCLIN/UMS/HCI platforms)
• Understanding of Medical Aid schemes and funder contracts.
Competencies
- Collaboration/ Relationship Building
- Resilience
- Engaging diversity
- Customer responsiveness
- Ethical behaviour
- Attention to detail
- Decision making
Departments
- Admin