Case / Claim Manager

Position Overview The Claims Consultant assesses and manages claims effectively and efficiently, within the required SLA, ensuring optimal profitability of the business. Responsibilities Claims assessment and management of Individual Life claims across all benefit types, for the South African operation, as well as other benefits relevant to the...

**Case Manager** **Position**: Case Manager **Department**: General and Specialized Case Management **Grade**: B4M1 **Position Purpose**: **Experience**: 5 years ward experience, 2 years’ experience hospital scheme case management advantageous **Qualifications**: Degree / Diploma in nursing, midwifery, and psychiatry. Current SANC professional nursing...

What will you do? This career opportunity is available at SHA Risk Specialists a division of Santam for the Claims Specialist: PI, who will be based in Johannesburg, Illovo. What will make you successful in this role? Claims Practice Management Attend and manage all aspects related to a portfolio of specialist claims such as claims registration, case...

**Job Advert Summary**: This role reports to the Team Manager Claims. Responsible for assessment and management of long-term Sickness, Permanent Incapacity and Disability claims. The role will transfer specialist claims knowledge, in-depth process knowledge and client centric principles. The incumbent will deal with technical and complex claims queries...

To plan, coordinate and execute case management work at hospital level. The incumbent utilities clinical knowledge to minimise financial risk and ensure accurate billing through comprehensive accurate coding of patient care. **Minimum Requirements**: - Relevant Nursing qualification. - CM or Billings Clerk with ICD training and anatomy and physiology...

One of our leading clients offering comprehensive financial solutions that include bond pre-approvals, home loans, short-term insurance, life insurance and more through its various subsidiaries is looking to build their Dream team with the Right People. JOB PURPOSE: As Business Claims Specialist you will provide support to the Product Manager, reviewing...

3Sixty Health has a great opportunity for a suitably qualified individual to fulfil the advertised position and join their team. 3Sixty Health is a black owned and managed, reputable and a major player in driving South African economy by investing **3SIXTY HEALTH **in ‘’black excellence’’3Sixty Health is 100% black owned and black managed...

Who we are American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience, today AIG member companies provide a wide range of property casualty insurance, life insurance, retirement solutions, and other financial services to customers in more than 80 countries and jurisdictions. These diverse...

SENIOR COMPLEX CLAIMS EXAMINER Who we are American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience, today AIG member companies provide a wide range of property casualty insurance, life insurance, retirement solutions, and other financial services to customers in more than 80 countries and...

What youll be doing if you get the job: The purpose of this role is responsible to drive the formulation and implementation of the risk model and underwriting philosophy, analyse claims and other data when assessing claims. Providing feedback on all claims, liaising with relevant stakeholders, and utilise their skills, knowledge and experience to make...

What youll be doing if you get the job: The purpose of this role is responsible to drive the formulation and implementation of the risk model and underwriting philosophy, analyse claims and other data when assessing claims. Providing feedback on all claims, liaising with relevant stakeholders, and utilise their skills, knowledge and experience to make...

Exciting opportunity in Gauteng! Looking for a someone that will be responsible for the liaison between the patients and managed healthcare. **Requirements**: - B Degree Nursing Qualification or equivalent NQF level 6 - Hospital case manager experience advantageous - 3 years’ experience in patient care - SAP experience preferrable

The Claims Manager is responsible for the overall management of the claims department. The duties include, managing, planning, monitoring and reporting. Providing assistance to Client Services, the Call Centre, Claims team, employers and external service providers. The Claims Manager reports to the Snr Manager PSSPF.Areas of ResponsibilitiesMeet production...

**Job Advert Summary**: This role reports to the Team Manager Claims. Responsible for assessment and processing of short-term Sickness, Critical Illness and Hospital claims. The incumbent will deal with technical and complex claims queries and/or complaints providing an excellent service offering. **Minimum Requirements**: **Education**: - Medical...

2024-03-04 - 2024-03-15 - Temp - CT004217 - Medical, Pharmaceutical & Nursing- Gauteng, JHB - Southern Suburbs - R 160 - R 180 Hourly Basic Salary (statuary benefits)- Private Hospital in JHB Southern Suburbs in need of a Temp Case Manager, must be registered on SANC as a RN and have experience as a case manager with clinical knowledge in the risk management...

A Medical Insurance company based in Benoni is looking for a Manager to Manage the Pre-Auth and Claims department. The Manager will manage the accurate and timely processing of claims within established legal and company compliance guidelines. Manage the pre-authorisation department and facilitate the process of pre-authorisation as per requests from members...

Responsibilities and work outputs Contribute to the ongoing enhancement and execution of the claims assessment methodology across Critical Illness, Income Protection and Lump Sum Disability benefit lines.Approves or declines claim submissions without supervision within company guidelines.Selects and accepts major risks on behalf of the company, evaluating...

FEM’s job vacancy, Career and Recruitment Job title : Claims Quality Assurance Analyst – JHB jobs in Gauteng Job Location : Gauteng, Johannesburg Deadline : March 22, 2024 Quick Recommended Links Jobs by Location Job by industries The successful candidate will be responsible for conducting interbranch claims audits by assessing potential risks and...

**Position**: Case Manager In Hospital **Position Purpose**: To coordinate care in allocated facilities, in order to improve health outcomes and manage the cost to the Scheme(/s). The case manager's responsibilities start from patient admission to discharge and they should have an understanding of hospital processes and the importance of making...

What will you do? Santam is the market leader in the general insurance industry in Southern Africa. We are a large, diversified, expanding and transforming company and whilst based in South Africa, we are rapidly moving into a number of emerging markets, both in Africa and Asia. Our success is rooted in our passion for our clients and everything we...