Billing Operations Centre BOC Clinical Coder

We provide meaningful careers that connect people with purpose.

We are united by a common purpose of providing the best and safest care; and by our shared values of Care, Truth, Participation, Compassion and Dignity.

Netcare invites you to be part of our journey.

Under the direction of the Clinical Coding Specialist (CCS), a Clinical Coder (CC) will be responsible in collaboration with billings teams, for liaising between patients, treating clinicians and managed care organisations to provide accurate and complete coding on updates and claims.

Job Responsibilities:

* Review and analyze patient medical records, including physician notes, operative reports, discharge summaries, and diagnostic test results, to extract relevant clinical information.
* Accurately assign ICD-10-CM and CPT codes to diagnoses and procedures in accordance with official coding guidelines, Netcare policies, and payer requirements.
* Ensure all coded data accurately reflects the services rendered and the patient's clinical condition.
* Identify and query physicians for clarification or additional documentation when necessary to support accurate code assignment and ensure compliance.
* Maintain a thorough understanding of current coding regulations, reimbursement methodologies, and industry changes.
* Collaborate with clinical staff, billing specialists, and other BOC team members to resolve coding discrepancies and improve documentation quality.
* Participate in internal and external coding audits and provide supporting documentation as required.
* Contribute to the continuous improvement of coding processes and workflow efficiency within the BOC.
* Adhere to all confidentiality and privacy regulations (e.g., POPIA, GDPR).
* Perform other ad-hoc duties as assigned by management.

Job Qualifications:

* Relevant National Diploma or Degree in Health Information Management, Nursing, or a related healthcare field.
* Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification is essential.
* Minimum of 3-5 years of experience in clinical coding, preferably within a hospital or private healthcare setting.
* In-depth knowledge of ICD-10-CM and CPT coding systems and official coding guidelines.
* Proficiency in medical terminology, anatomy, physiology, and disease processes.
* Strong analytical and problem-solving skills with meticulous attention to detail.
* Excellent written and verbal communication skills to effectively interact with clinicians and other stakeholders.
* Ability to work independently and as part of a team in a fast-paced, high-volume environment.
* Proficient in using electronic health record (EHR) systems and coding software.
* Demonstrated commitment to continuous professional development in coding and healthcare regulations.

Join the team committed to providing the best and safest health and care.