Job Description
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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