Clinical Coding Specialist

Job Description

We are seeking a qualified and experienced Clinical Coding Specialist to join our healthcare team. The successful candidate will be responsible for ensuring the accurate clinical coding of healthcare services and maintaining compliance with industry standards and coding guidelines within a Managed Healthcare environment.

Minimum Requirements

  • Relevant qualification in Nursing, Pharmacy, Physiotherapy, or another Health Sciences discipline.
  • Registration with the relevant South African statutory professional body (e.g., SANC, SAPC, HPCSA, or other applicable professional council).
  • Minimum of 5 years' experience in clinical coding within a Managed Healthcare environment.
  • Proven experience working with:
  • Reference Price List (RPL)
  • International Classification of Diseases, Tenth Revision (ICD-10)
  • Complete Current Procedural Terminology for South Africa (CCSA)
  • National Pharmaceutical Product Interface (NAPPI) coding
  • Sound understanding of healthcare funding, medical schemes, and claims adjudication processes.
  • Proficiency in Microsoft Office and healthcare information systems.
  • Excellent analytical, communication, and problem-solving skills.
Key Responsibilities
  • Accurately assign ICD-10, CCSA, RPL, and NAPPI codes to clinical records and medical claims.
  • Review clinical documentation to ensure coding accuracy and completeness.
  • Ensure compliance with national coding standards, medical scheme rules, and regulatory requirements.
  • Validate coding for medical claims processing and reimbursement.
  • Identify, investigate, and resolve coding discrepancies and queries.
  • Collaborate with healthcare professionals to improve clinical documentation and coding quality.
  • Conduct coding audits and implement quality assurance measures.
  • Provide guidance and support on coding standards and best practices.
  • Prepare coding reports and contribute to performance monitoring and compliance initiatives.
  • Keep up to date with changes to coding standards, healthcare legislation, and industry guidelines.
Preferred Skills
  • ICD-10 coding
  • CCSA coding
  • RPL application
  • NAPPI coding
  • Medical claims coding
  • Clinical documentation review
  • Managed Healthcare knowledge
  • Quality assurance and auditing
  • Attention to detail
  • Excellent communication and interpersonal skills
How to Apply If you meet the above requirements and have the relevant experience, click Apply Now and submit your updated CV together with proof of your professional registration and qualifications.

Only shortlisted candidates will be contacted.

Work Location: Hybrid remote in Rosebank, Gauteng

Back to blog

Other Jobs To Apply

No other job posts for this day.

Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...