Hospital Benefit Management

2 weeks ago


Pretoria, Gauteng, South Africa Medpharm Recruitment Full time

A reputable Medical Aid is seeking a Nurse who has experience within the Medical Aid environment, to join their HBM Case Management team.


Duties:

  • Providing clinical knowledge of hospital preauthorisation and Case Management of hospital cases in order to take cost effective and appropriate decisions in evaluating treatment, LOS and LOC.

Requirements:

  • Grade 12 / Matric
  • B Cur Nursing Degree / Diploma: Registered Nurse (SANC)
  • A minimum of 1 year experience working within a Medical Aid environment
  • Knowledge of current coding structures (ICD 10 / CPT 4 / NRPL / PMB Conditions)
  • Experience working with Medical Aid Scheme Rules and protocols
  • Excellent communication skills
  • Team Player
  • South African born citizen
  • Credit and Criminal Clear

Job Types:
Full-time, Permanent

Salary:
R1.00 - R2.00 per year

Application Question(s):

  • What roles have you worked in the Medical Aid environment?
  • What is your minimum salary? (Before deductions)

Education:

  • Diploma (required)

License/Certification:

  • SANC (required)


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