Medical Reviewer

Inizio Medical has built a large team of medical writers in South Africa, becoming the leading medical communications company in Africa. We are recruiting for a new intake of medical writers who will start with us in March 2025. Our teams in South Africa work alongside our global teams (based in the US, UK, South Africa and EU) in our three med comms...

We are recruiting for a Medical Claims Review Officer position. **Key Performance Areas** **Audit & review medical bills.** - Analysis of claimed items/services in correlation with available tariff structures and ICD 10 /CPT 4 codes. - Requesting motivation for unreasonable accounts. - Line by line analysis of claim items/service. Matching those appropriate...

Key Performance AreasAudit & review medical bills.Analysis of claimed items/services in correlation with available tariff structures and ICD 10 /CPT 4 codes.Requesting motivation for unreasonable accounts.Line by line analysis of claim items/service. Matching those appropriate tariffs/ICD/CPT codes.Flagging rejected items/services.Recommendations to...

Key Performance Areas Audit & review medical bills. Analysis of claimed items/services in correlation with available tariff structures and ICD 10 /CPT 4 codes. Requesting motivation for unreasonable accounts. Line by line analysis of claim items/service. Matching those appropriate tariffs/ICD/CPT codes. Flagging rejected items/services. Recommendations to...

Key Performance Areas Audit & review medical bills. - Analysis of claimed items/services in correlation with available tariff structures and ICD 10 /CPT 4 codes. - Requesting motivation for unreasonable accounts. - Line by line analysis of claim items/service. Matching those appropriate tariffs/ICD/CPT codes. - Flagging rejected items/services. -...

**Division**: Regulatory Affairs **Department**: Medical Affairs **Employment Type**: Permanent **Job Purpose**: South Africa and Sub-Saharan Africa: Develop, control and shape strategies for all therapeutic areas; provide and ensure dissemination of ethical, scientifically correct and balanced information for execution to the respective stakeholders;...

**ABOUT US**: CoGrammar, a subsidiary of HyperionDev, is an ed-tech startup that is dedicated to closing the global tech skills gap. We achieve this by integrating human code review into the world's leading businesses. CoGrammar has also built and scaled its own coding education product (HyperionDev) which supports learners from over 40 countries in changing...

**Prospective Reviewer (Pre-Authorization Call Centre)** The Prospective Reviewer role within the pre-authorization call centre, is responsible for authorizing hospital authorization requests ensuring that requirements of clinical appropriateness, medical necessity and clinical risk management are met. **Key Activities**: - Capture accurate...

**Position Overview** Overview** This is a Permeant role with part time hours Serves as a medical consultant to the South African markets for traditional life underwriting, living benefits and claims. Evaluates medical tests/information, assesses risks, and research medical procedures and information. Provides ongoing education and training for...

**Division**: Regulatory Affairs **Department**: Medical Affairs **Employment Type**: Permanent **Job Purpose**: Generate and provide scientific know-how in designing promotional strategies, supporting sales force development, regulatory, pharmacovigilance, training, compliance/ethics, and other scientific communications, in order to shape the assigned...

Prospective Reviewer (Pre-Authorization Call Centre)   The Prospective Reviewer role within the pre-authorization call centre, is responsible for authorizing hospital authorization requests ensuring that requirements of clinical appropriateness, medical necessity and clinical risk management are met.   Key Activities: Authorizing hospital authorization...

Prospective Reviewer (Pre-Authorization Call Centre) The Prospective Reviewer role within the pre-authorization call centre, is responsible for authorizing hospital authorization requests ensuring that requirements of clinical appropriateness, medical necessity and clinical risk management are met. Key Activities:Authorizing hospital authorization requests...

Genesis Medical Scheme wishes to appoint a suitably qualified nursing sister to assist in the reviewing and capturing on system of oncology related treatments. **REQUIREMENTS**: Receipt and assessment of all motivations and treatment plans for oncology treatment (chemo - and radio-therapy) in accordance with the Scheme rules and current...

Inizio Medical is growing! We are growing our team of medical writers based in South Africa. Our South African team works alongside our global teams in ApotheCom, Nucleus Global and Ashfield Medical Communications across the US, UK and EU, which will give you the opportunity to work on cutting edge projects, working at the forefront of drug development and...

EE Position **Position Purpose** To research, develop, review and communicate reimbursement guidelines and policy for the company and clients, including drug and technology policy. Such policy to be communicated to clients, internal business units and external stakeholders, as required. To develop and maintain a clinical governance framework for managed...

ApotheCom, an exciting and innovative medical agency, is growing! We are growing our team of medical writers based in South Africa. Our South African team works alongside our global teams based in the US, UK and EU, which will give you the opportunity to work on cutting edge projects, working at the forefront of drug development and commercialization. Drawn...

We are looking to recruit for our marketing department here at ICG Medical. We are a multi-brand / multi-location business and we need a Social Media Executive to come on board to co-manage our social media channels. To be successful, you must be able to perform the below duties day-to-day: - Design and implement social media strategy to align with...

**Position Purpose**: To facilitate the setting of quality standards, policies, and procedures (clinical and non-clinical) for area. Ensure adherence to audit requirements, reporting and planning through evaluation, and coaching internal resources. **Experience**: 5 years’ experience in the Managed Care environment in pre-authorisation call centre/...

**Job Number** - 71774 **Job Type** - Permanent **Job Title** - Medical Officer **Computer Skills** - Ms Office **Industry** - Medical Practice **City** - Cape Town **Province** - Western Cape - Take work load off oncologists, creating capacity. Patient care.- Routine follow-ups; Chemotherapy follow-ups; Radiotherapy treatment checks; Emergencies ;...

Our client is in the medical service industry offering cutting edge technology to the market and the primary job responsibilities associated with the appointment of this position are as follows: - In theatre Clinical Technical support of image guided surgery systems. - Collection of equipment and stock from suppliers and clients. - Installation, Repair,...