Clinical Coder / Care Risk Manager / Operations Manager
LenMed Clinic- Johannesburg
Total years of experience :15 years, 1 Months
• Ensure coding has been entered accurately by Case Managers and correct any incorrect ICD 10 and CPT codes.
• Ensure minimal risk of losses to Hospital
• Liaise with Medical Aid’s with regards payment of all outstanding monies owed to Service Provider.
• Ensure that patient confidentiality is protected
• Maintain communication processes.
• Provide monthly coding report to Hospital Manager
• Co-operate and work well with other departments to ensure compliance and timeous submission of accounts.
• Ensure that turnaround time is upheld to prevent non-payment or penalties by Medical Scheme.
• Deal with queries as required
• Assess Casualty and In Patient files
• Ensure timeous update of medical information with Medical Schemes with regards their member’s condition.
• Ensure minimal risk of losses to Hospital.
• Liaise with patients and inform of any changes with regards payment from Medical Aid Fund.
• Ensure that patient is aware of any outstanding amounts which medical aid does not cover.
• Ensure that turnaround time is upheld to prevent non-payment or penalties by Medical Scheme.
• Liaise with Doctor’s with regard motivation letters required by scheme and forward to relevant Case Manager at Fund.
• Ensure that patient confidentiality is protected and all rights pertaining to patient’s Bill of Rights.
• Deal with queries from Member’s, patient’s, doctors’ as well from Medical Scheme
The administration of a business includes the performance or management of business operations and decision making, as well as the efficient organization of people and other resources, to direct activities toward common goals and objectives. ... A business administrator oversees a business and its operations
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