Clinical Claims Adjudication

**THE JOB AT A GLANCE** As a Clinical Claims Adjudication, you will be reporting to the Clinical Claims Adjudication Team Leader, you will be responsible for effective and efficient adjudication of COIDA and Non-COID (diseases and accidents) i.e. ICD10 codes, Authorisation of treatment, TTD (Temporal Total Disability), claims estimates, Management of Claims...

**THE JOB AT A GLANCE** As the Senior Claims Assessor, you will be reporting to the Team Leader: Senior Claims Assessor. You will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance. **WHAT WILL YOU DO?** **Adjudicate on claims**: - Adjudicate claims...

**THE JOB AT A GLANCE** As a Life Claims Assessor, you will be reporting to the Partner Claims Specialist - Life, you will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance. **WHAT WILL YOU DO?** **Claims Adjudication**: - Verify claims captured for...

**Purpose** To effectively and efficiently process and adjudicate Funeral Fund Claims, within the scope of the Funeral Fund policy rules and prevailing legislation. Also, to enhance and improve customer experience through effective assessment of claims and meeting the requirements and expectations of the role set out below. **Qualifications and Experience...

Job Summary:To plan, coordinate and execute case management work for RAF Business in the CHG Facilities. The incumbent utilises clinical and RAF knowledge in managing RAF Business in the facilities to minimise financial risk and ensure accurate billing through comprehensive accurate coding and classification of RAF available products offered in the...

**THE JOB AT A GLANCE** As a Life Claims Assessor, you will be reporting to the Claims Manager: Life, you will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance. **WHAT WILL YOU DO?** **Effectively and efficiently perform the function of a Funeral...

**Job Advert Summary**: An exciting new **OSTI Specialist **opportunity has just become available in our **Insure, Operations (**Customer Experience Area).** **Role Objectives** To be part of the team that deals with complaints that have been escalated from the ombudsman office or by customers and/or brokers requesting adjudication on internal complaints....

**THE JOB AT A GLANCE** As the Pensions Medical Case Assessor (PMCA), you will be responsible for effectively and efficiently rendering medical support to internal and external stakeholders. **WHAT WILL YOU DO?** - Monitoring of Hospital Admissions weekly and liaison with Case Managers. - Give feedback to Case Managers and other Colleagues of Pensioners...

**Job Advert Summary**: Helloan exciting new opportunity has just become available in our **Hollard Life Solutions, **in the **Business Assurance** area.** We are looking to recruit a **Ombudsman and OIA Case Specialist** **Role Objectives**: The primary purpose of the job is to receive and investigate complaints received directly from the National...

**THE JOB AT A GLANCE** As the Head of HealthCare, you will be reporting to the CEO of COID & Group Operations.You will be responsible for providing strategic direction and evaluation of the sub-acute rehabilitation centre and fostering sustainable interdisciplinary collaboration towards achieving the goal of successful and cost-effective rehabilitation for...

**Job Advert Summary**: Helloan exciting new opportunity has just become available in our Insure, Business Assurance area. We are looking to recruit a Legal Advisor Role Objectives This function will be focused on assisting the business to manage its legal risk. Legal risk is the risk to business resulting from any of their rights not being fully...

**Main purpose of the job**: - To provide support to the Executive Director **Location**: - **Ezintsha - 32 Princess of Wales Terrace, Parktown - Johannesburg** **Key performance areas**: - Proactive diary management - Arrange meetings - take minutes, assemble, and distribute meeting packs timeously, follow up on meeting actions and track progress - In...