Clinical Assessor at Mediclinic

MAIN PURPOSE OF JOB

• To minimise operational and financial risk by ensuring the correct allocation of clinical coding and the appropriate level of care for all cases.

KEY RESPONSIBILITY AREAS

• Minimise the financial risk by effectively assessing the Patient Report Form to ensure the correct Level of Care is allocated
• Ensure compliance to contracts, legal aspects and Clinical Practice Guidelines by utilising available resources and systems
• Apply clinical coding and ensure that coding standards are adhered to
• Ensure correct and timeous finalisation of cases to facilitate reimbursements from funders
• Identify and refer gaps or risk in clinical practice to minimise operational and financial risks and participate in quality enhancement projects that will improve the quality of clinical information documented as well as improve patient care

REQUIRED EDUCATION

ESSENTIAL EDUCATION:

• Relevant Clinical Qualification

DESIRED EDUCATION:

• EMS Qualified

REQUIRED EXPERIENCE

ESSENTIAL MINIMUM EXPERIENCE:

• Experience within the Medical Services environment

DESIRED EXPERIENCE:

• Experience in a clinical role; Experience in EMS healthcare environment; Medical aid background; Clinical Coding

REQUIRED JOB SKILLS AND KNOWLEDGE

• Demonstrates competence on SAP and the application thereof
• Clinical knowledge in respect of emergency medical services and the application of the Clinical Practice Guidelines
• Relevant aspects of applicable statutory acts / regulations (e.g. Medical Schemes Act, PMB’s, HCPSA Guidelines, POPIA, etc.)
• Demonstrates solid knowledge of rules and regulations regarding funder contracts, and the application thereof e.g. the application of authorisations and motivations for level of care
• Application of clinical codes in the EMS environment
• Demonstrates solid knowledge of anatomy and physiology and terminology
• Demonstrates solid knowledge of, and consistently acts according to Patient Administration policies and procedures
• Data Analysis
• Computer literacy (e.g. Outlook and intranet applications)

Closing date: 21/08/2025