Design & Dtp Specialist (Medical Aid Scheme)

**Design and DTP Specialist** **Company** One of the largest private Medical Aid companies in SA. They have been established for 20 years and are striving to be #1 in SA. **Purpose** Creation of visual elements for web, print and screen **Responsibilities** - Graphic Design & DTP - Communication, forms, guides, annual reports, presentations and other...

The purpose of this position is to ensure that all claims are assessed using the appropriate rules and is paid correctly in line with the Scheme's benefit and tariff structures. **Duties**: - Assessing and processing Medical Aid claims - **Quality**:Measuring of individual error rate to ensure no costs incurred due to assessing errors made. -...

reputable Medical Aid is seeking a Junior PMB Consultant to join their team in Pretoria. **Duties**: - Administration of PMB and CDL treatment plan authorisations - Managing PMB referrals and supervising escalation inbox - Daily stats reporting - Supporting the Manager/Team Leader and other Managers in tasks and initiatives beneficial to the teams and to...

A reputable Medical Aid based in Pretoria is seeking a Risk Specialist to ensure that the Scheme maintains an adequate and effective Risk Management program. The position is responsible for promoting Risk and Regulatory compliance by identifying, quantifying, reviewing, evaluating, and measuring risk to ensure that all risk categories are identified and...

A reputable Medical Aid Scheme, based in Pretoria, is seeking a Pre-Authorisation Consultant to join their Hospital Benefit Management team. **Duties**: - Delivering cost-effective managed healthcare services to accomplish member satisfaction. - Assisting the Client by approving appropriate funding. - Delivering an effective Call Centre service in order to...

A reputable Medical Aid Scheme is seeking an experienced Risk Analyst to join their team in Pretoria. A reputable Medical Aid Scheme based in Pretoria is in search of an experienced Risk Analyst to join their team. **Job Purpose**: - The position is responsible for promoting risk and regulatory compliance by identifying, quantifying, reviewing,...

A Medical Aid in Pretoria is seeking a Service Provider Practice Consultant to join their Service Providers, Contracting and Research Department. **Duties**: - Proactively manage short paid and overcharged claims. - Increasing referrals to top-ranked Specialists. - Compiling, sharing and regularly updating Q&A documents and arranging Q&A sessions for staff...

Our client, a managed care organisation based in Pretoria is looking for a Call Centre Agent. This is an equal opportunity organisation with various businesses and/ or subsidiaries that service clients in the medical scheme and insurance industries. Position: Medical Call Centre Agent - Adding or removing of dependants - Processing medical scheme membership...

A reputable Medical Aid is seeking an experienced DUR Pharmacist to join their team in Pretoria. **Duties**: - Medicine authorisations as per Scheme rules and protocols to ensure cost-effective reimbursement of medicine and medicine cost containment. - Ensure medicine benefit allocations are applied and executed correctly according to Scheme...

Job Title: Medical Scheme AdministratorWe are seeking a highly organized and detail-oriented Medical Scheme Administrator to join our team at HR Options.Key Responsibilities:Client Interaction & Administration:Provide exceptional customer service to clients, ensuring their administrative requirements are met in a timely and efficient manner.Ensure compliance...

KPAsü Assist the Chief Healthcare Officer in executing all clinical and medical advisory services within the HealthcareManagement division and maintain clinical oversight on all aspects of the Schemes business.ü Ensure that the execution of clinical and medical advisory services within the Organisation are sound and incompliance with the Medical Schemes...

Job Title: Medical Scheme AdministratorWe are seeking a highly skilled and experienced Medical Scheme Administrator to join our team at HR Genie.About the Role:The successful candidate will be responsible for providing administrative support to our medical scheme clients, ensuring that all client documentation is in compliance with FICA & FAIS...

A reputable Medical Aid is seeking a Dental Administrator to join their Hospital Benefit Management team in Pretoria. Please note: This is an office-based role. **Job Purpose** To improve overall operational efficiency and ensure an optimal member experience by assisting with dental authorisations, enquiries and feedback. **Summary of duties** - Client...

At HR Genie, we are seeking a highly skilled Medical Schemes Administrator to join our team. The successful candidate will have excellent knowledge of English and Afrikaans and experience in financial services, medical schemes, or a related administrative environment.Key Responsibilities:Client Interaction & Administration:Regular interaction with clients,...

A reputable Medical Aid is seeking a Rules & Tariff Master to join their Claims Department. This role will ensure that the tariffs and rules are loaded correctly on the Administration System and to maintain this function with regards to updates and changes. **Duties**: - Providing effective communication to staff and Management on changes in the industry,...

A reputable Medical Aid is seeking a Pre-Auth Consultant to join their Call Centre team in Pretoria. A reputable Medical Aid Scheme, based in Pretoria, is seeking a Pre-Authorisation Consultant to join their Hospital Benefit Management team. **Duties**: - Delivering cost-effective managed healthcare services to accomplish member satisfaction. - Assisting...

A reputable Medical Aid is seeking an experienced Medical Aid Claims Assessor to join their HBM team in Pretoria. (Office based) **Requirements**: - Grade 12 - Staff/Enrolled or Registered Nurse (SANC) - Minimum 5 years’ experience as a Nursing Practitioner - Minimum 1 year experience gained in the medical funding industry - 1 year Medical Aid claims...

A reputable Medical Aid is seeking a Junior PMB Clinical Assistant to join their Pharmaceutical Benefit Management Department in Pretoria. Please note, this is an office-based role. **Duties**: - Administration of PMB and CDL treatment plan authorisations. - Managing PMB referrals and the Supervisor escalation inbox. - Daily stats report. - Providing...

Job Title: Case Manager - Medical AidMediHelp is seeking a skilled Case Manager to join our team. As a Case Manager, you will be responsible for managing and coordinating the care of our members, ensuring they receive the best possible medical treatment and support.Key Responsibilities:Plan and optimize daily tasks to update cases on the hospital list within...

A reputable Medical Aid is seeking an experienced Consultant to join their Service Providers, Contracting and Research Department. **Job Purpose**: To provide optimal support to the Healthcare Providers on the network, expand the network and to promote the Scheme. **Duties**: - Proactive Management for short paid claims and Overcharged Claims. - Increase...