Pre-Admissions Clinical Assessor

About the role

A vacancy exists for a Pre-Admissions Clinical Assessor based at Life Fourways Hospital, reporting to the Patient Services Manager, Sibahle Xhali. The post manages the financial and clinical administrative risks associated with future patient admissions.

Key responsibilities

• Perform clinical assessments and document clinical history, and ensure pre-admissions are clinically coded according to coding standards
• Ensure efficient, proactive pre-admission of all patients in line with group protocol, liaising closely with Case Management and the National Credit Risk Department to minimise risk exposure
• Maintain high-quality documentation and supervise and train staff at the Pre-Admission Clinic
• Manage bed and theatre bookings through liaison with ward and doctors' rooms
• Handle authorisation requests and benefit confirmations (e.g. prosthesis benefit confirmation) and monitor insurance verification with funders
• Monitor workflow, identify gaps and risks and implement corrective actions, and drive compliance with LHC policies on authorisations and deviations
• Ensure quality outputs meet ISO 9001 standards, run quality walkabouts, monitor Q-evaluator scores and lead quality improvement programmes through power teams
• Investigate internal and external stakeholder complaints, manage escalated concerns from Case Managers and uphold service level agreements
• Assist the case management team when operationally required and foster healthy relationships with internal and external stakeholders

Required profile

• Diploma or degree in Nursing, Physiotherapy, Clinical Associates, Paramedics as Critical Care Assistants or Emergency Care Practitioners, or another qualification covering Anatomy, Physiology, Pathophysiology and Microbiology
• Current SANC registration
• Knowledge of hospital patient services and case management processes
• Understanding of the private hospital industry and practices

Required skills

• CPT and ICD coding
• Funder contracts, scheme rules, exclusions and benefits
• Computer proficiency
• Problem-solving, analysis and judgement, resilience, communication, influencing and ethical behaviour