Road Accident Fund Recruitment 2023/2024
Applications are invited from interested and suitably qualified candidates for Road Accident Fund Recruitment 2023/2024.
The Road Accident Fund (RAF) provides compulsory cover to all users of South African roads, citizens, and foreigners, against injuries sustained or death arising from accidents involving motor vehicles within the borders of South Africa. This cover is in the form of indemnity insurance to persons who cause the accident, as well as personal injury and death insurance to victims of motor vehicle accidents and their families.
We are recruiting to fill the following position below:
Job Title: Clinical Coder T.A.S.K Level 15
Purpose of the Job
Reporting to Manager: Medical Tariffs and Pharmaceuticals, the successful incumbent is accountable for the sourcing, development and maintenance of clinical rules database, clinical coding and tariffs. To update and develop coding crosswalks, perform quality assurance on coding and facilitate the training process of staff on ICD 10 coding, working in conjunction with the IT team, Learning and Development and the Medical healthcare team.
Duties & Responsibilities
Key Performance Areas
Lead and Develop Clinical Coding and Tariffs within the protocol development Team
- Provide clinical coding input for the design and maintenance of in and out of hospital specific baskets of treatments for various conditions.
- Develop, update and maintain the RAF Tariff
- Assist with the correct maintenance of ICD10, NRPL, Nappi, and CCSA codes on the system.
- Provide support to the business on coding issues.
Training and Transfer of Coding Knowledge and Provide Coding Information and Support for the Road Accident Fund
- Provide CRM support to various units within the organization and resolve their clinical coding and systems queries.
- Assist with clinical input on the implementation and maintenance of the Rules Engine project for all tariffs and modifiers at medical invoice processing and pre-authorisation level.
- Attend ICD10 code workshops and workshops on tariff structures conducted by SAMA, DOH, Clinical Coding committee, and other official bodies and provide feedback to business and IT
- Provide coding support and feedback at various case management and claims meetings.
Policy review and implementation
- Contribute to the development and implementation of departmental policy, procedures and processes.
- Keep up to date with effective policy and practice execution strategies.
- Liaise with medical doctors and other external service providers on coding and clinical issues.
- Support in the identification, development and implementation of cost-effective processes in order to increase efficiency and reduce cost drivers related to the area of specialization
- Liaise with external role players regarding tariffs and coding and keep abreast of changes and developments within the medical industry.
- Ability to interact with other stakeholders within the organisation, including ICT for development of system automation of baskets of care for MVA clinical conditions.
- Prepare and submit regulation reports as and when required to provide progress updates and/ or inform management decisions.
- Develop reports/ policies/ procedures and guide the process through the alignment of the documents to the overall RAF’s Strategy.
- Develop functional reporting systems, for management, projects or performance reporting.
- Prepare proposals, briefings, presentations, reports, and other documentation and provide management information both verbally and in report format.
Administration and Report Writing
- Collect relevant statistics to inform future decisions.
- Compile monthly reports.
- Ensure processes are in place to have accurate and timeous information on coding.
- Perform administrative duties as and when required.
Desired Experience & Qualification
- Bachelor’s Degree/ Advanced Diploma in health science/ Nursing /Pharmacy /Physiotherapy related qualification.
- Intermediate to Advanced ICD10/ CPT4 Coding qualification/ certification.
- Relevant 5 – 7 years coding work experience in a Managed Healthcare environment.
- With experience in NRPL, ICD, CPT and Nappi coding, and doing crosswalks.
- With experience in training in ICD 10 coding NHRPL, and CPT coding.
- With experience in creating clinical coding crosswalks for system development
Package & Remuneration
- R891 176.00 per annum, negotiable.
How to Apply
Interested applicants should kindly visit the company website to get more details and submit the application(s).