Specialist: Mapping Coder at Liberty Group South Africa

Purpose

• To develop and maintain coding and tariff structures as well as the maintenance of a clinical rules database for Liberty Health and the Rest of Africa.

Minimum Experience

• 2 - 3 years experience in a similar environment

Minimum Qualifications

• National Diplomas and Advanced Certificates [NQF Level 06] in Promotive Health and Developmental Services

Additional Minimum Qualifications

Outputs

Process

• Accountable for the execution of specialised work including the improvement of quality, standards and outputs within defined work routines and operating procedures.
• Proactively solves problems, determines root-cause and applies solutions in line with guidelines and providing the necessary information to solve problems related to area of specialisation.
• Plan for own task execution and advises on improvements related to area of specialisation.
• To ensure the accurate mapping of scheme benefit rules
• To assist in the development and maintenance of a coding structure and process that enables the business to conduct claims management and clinical analyses
• To ensure SLA’s with clients and other departments (both back-office and in-country) is maintained
• To ensure the effective development and implementation of cross-mapping of provider codes across the African continent.

Customer

• Ensure own understanding and adherence to customer service delivery and Treating the Customer Fairly (TCF) principles to provide specialist support and guidance.

Finance

• Adhere to specified standards, policies and procedures to prevent potential losses/wastage related to the area of specialisation.

Learning and Growth

• Contribute positively to own area-specific knowledge improvement associated with area of specialisation.

Governance

• Comply to set governance and compliance procedures and processes related to an area of work and continuously identify, rectify and escalate risks where necessary.

Competencies

Liberty Values

Technical Competencies

• Research and Information Gathering (Basic)
• Decision Making and Problem Solving (Basic)
• Communication skills (Fundamental) (Basic)

Behavioural Competencies

• Analytical Thinking (Basic)
• Customer Orientation (Basic)
• Customer service orientation (Basic)
• Organisation and Attention to Detail (Basic)
• Interpersonal Effectiveness (Basic)
• Teamwork and Cooperation (Basic)
• Adaptability (Basic)
• Problem Solving and Analysis (Basic)
• Communicating with Impact (Basic)
• Professional/Technical learning (Basic)