Full Job Description
CPT coding and an understanding of coding standards
ICD 10 coding and an understanding of coding standards.
Multi-disciplinary clinical experience and knowledge of medical terminology.
Excellent communication skills.
Attention to detail.
Valid driver's licence and ability to travel.
Ability to work extended hours.
Min of 3 years
experience in Clinical Coding and or Case management in a hospital environment
Intermediate computer proficiency.
Diploma in Nursing or equivalent NQF level 6 qualification within healthcare sciences.
Certificate in Advanced ICD-10.
SANC registration as a Registered Nurse.
Certificate in Advanced Complete CPT for South Africa
Managed Care Quality of coding
Work with billing departments to achieve clinical coding excellence on all patient files.
Application of clinical and coding knowledge to effectively assign and sequence all ICD 10 and CPT codes for
services rendered for each patient event.
Read and analyse records from all available digital and other resources for accurate and appropriate coding
that reflects the relevant medical history and care the patient received as well as the response to treatment.
Engage with all allied service providers to clarify information to ensure complete ICD 10 and CPT coding on
each case is achieved.
Allocate clinical codes to patients current period of care using knowledge of the information contained within
the International Classification of Diseases, revision 10, and CPT coding books.
Conduct assessment of work to make sure that it is continuous improvement in ICD-10 and CPT coding and
collection of quality health data.
Demonstrate expertise in clinical coding and the DRG model and an understanding of the complex cause and
effect factors within the broader managed care industry.
Continual assessment of work to ensure a continuous improvement in ICD-10 and CPT coding and collection
of quality health data.
Review and analyse clinical coding periodically during a patient event in relation to mapped clinical coding
Adherence to Netcare policy and procedure and measurement of performance within the designated key
Comply with all legal requirements regarding clinical coding procedures and practices
Actions that are guided by the South African Code of Ethics for Clinical Coders and South African coding
Clinical coding accuracy will be measured using reporting and trend analysis from the Netcare data analytics
Review of patient records for missing information.
Review of PMB queries and recommendations for action.
Communicate with funders about clinical coding errors and disputes.
Identify discrepancies, potential quality of care and billing issues.
Assist with adhoc case management required at hospital level.
Internal Customer Support:
Participate actively with the Netcare data analytics team to iteratively improve on coding trends and rejection
Provide support to the hospital billing department.
Assist with the training of staff with regard to ICD-10 and CPT coding.
External Customer Support:
Contact physicians and other health care professionals with questions about treatments or diagnostic tests
given to patients with regard to coding procedures. Serves as coding consultant to care providers.