CLINICAL AUDITOR at MEDICAL SCHEME

Job DescriptionUniversal Healthcare Group is seeking a Medical Claims Auditor to join their team. The successful candidate will be responsible for assessing diagnostic pathology consultations and claims from service providers.ResponsibilitiesAudit diagnostic pathology consultations and claims to ensure compliance with medical scheme rules.Monitor and control...

A well-established company is recruiting for aCLINICAL AUDITOR: HOSPITAL CLAIMSBRYANSTONPURPOSE OF THE JOBThe purpose of the role is to ensure that members get proper and appropriate medical treatment in accordance with the billing guidelines, while also protecting members' funds by ensuring that there is no abuse by members or providers. Ensure that all the...

**Business Unit**:Discovery Health **Function**:Clinical **Date**:27 Feb 2025 - Discovery Health - Strategic Risk Management - Clinical Researcher (CCE Surgicals) **About Discovery** - Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support...

About the RoleA leading organization, The Recruitment Council, is seeking an Administrative Support Specialist to join their dynamic team. This exciting opportunity is ideal for a detail-oriented and proactive individual who is passionate about providing exceptional administrative support in the areas of medical aid schemes.Key Responsibilities:Provide...

The Head Office of a large Private Hospital Group situated in Sandton, JHB, is seeking a Senior Clinical Internal Auditor, who will be accountable for planning and managing the execution of large and complex field audit engagements in the clinical audit space. The incumbent will assist the Internal Audit Manager in directing a comprehensive audit program (to...

Discovery's core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best. As global thought leaders,...

Job Title:Veterinary Account AuditorAbout the Role:This role is responsible for ensuring that all claims and duties are performed within agreed service levels with providers. The successful candidate will be accountable for auditing veterinary hospital accounts on a daily basis, utilizing clinical guidelines and protocols to make informed decisions.Main...

Medical AdvisorAbout DiscoveryDiscovery's core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best....

About Strategic Risk ManagementClinical Specialist (Doctor)Department Overview:We are a business-critical department in Discovery Health, holding the responsibility for ensuring sustainable and equitable management of scheme funds to deliver patient care.Job Description:Developing a vision, design (model, benefits, partners, build including operational...

**Business Unit**:Discovery Health **Function**:Clinical **Date**:5 Mar 2025 **Head of Clinical Benefit Advisory Services** **About Discovery** - Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values...