Hum Assessor

2 weeks ago

Parktown North, Gauteng, South Africa Rand Mutual Assurance Full time

THE JOB AT A GLANCE


As the HUM Assessor, you will effectively and efficiently process pre-authorisations for in-patient treatment for Compensation for Occupational Injuries and Diseases Act (COIDA) accidents.


WHAT WILL YOU DO?

  • Generate the preauthorisation and feedback to Medical Service Provider (MSP) timeously
  • Generate the hospital preauthorisation and feedback to MSP timeously
  • Generate preauthorisation for Chronic medication for nonpensioners and supply feedback to MSP
  • Authorise all Devices as per approval
  • Ensure that all mandatory tariff codes are captured on authorisation
  • Follow up on outstanding authorisation documents with Medical Service Providers
  • Review and updating of ICD10 codes
  • Preauthorisation of medical treatment in line with internal policies and Standard Operating Procedures
  • Submission of daily, weekly, and monthly reports to Management
  • Undertake relevant training as identified by line manager
  • Adherence to Company Policies and Standard Operating Procedures
  • Resolution of queries and complaints from stakeholders
  • Participation in Company projects as and when requested
  • Physio, Occupational Therapy and X-Rays
  • Consultations, day procedures and corneal transplants
  • Acute and chronic cases
  • Assist with reopening requests.
  • Adhoc duties

WHAT YOU'LL BRING TO THE TABLE?

  • Diploma or Degree in Nursing or related field
  • Minimum of 4 years nursing/medical aid environment experience
  • Registration with nursing council and related
  • Contributing to Team Success
  • Decision Making
  • Work Standards
  • Applied Learning
  • Managing work and time management
  • Stress tolerance
  • Nursing Protocol
  • Negotiation skills
  • Communication skills
  • Customer centric

WHAT WILL YOU GET IN RETURN?
We offer great opportunities for personal and professional development in a stable company that's 128 years strong. The role comes with a competitive salary package and various benefits. Flexible work arrangements (combination of remote and in the office). Furthermore, you will be a part of a dedicated group of colleagues who value teamwork and collaboration.

Turnaround time

Closing date: 5 April 2024

Our Commitment to transformation:

  • Diploma or Degree in Nursing or related field
  • Minimum of 4 years nursing/medical aid environment experience
  • Registration with nursing council and related
  • Contributing to Team Success
  • Decision Making
  • Work Standards
  • Applied Learning
  • Managing work and time management
  • Stress tolerance
  • Nursing Protocol
  • Negotiation skills
  • Communication skills
  • Customer centric

  • Hum Assessor

    2 weeks ago

    Parktown, South Africa Rand Mutual Assurance Full time

    **THE JOB AT A GLANCE** As the HUM Assessor, you will effectively and efficiently process pre-authorisations for in-patient treatment for Compensation for Occupational Injuries and Diseases Act (COIDA) accidents. **WHAT WILL YOU DO?** - Generate the preauthorisation and feedback to Medical Service Provider (MSP) timeously - Generate the hospital...