Hum Assessor

3 weeks ago


Parktown, South Africa Rand Mutual Assurance Full time

**THE JOB AT A GLANCE**

As the HUM Assessor, you will effectively and efficiently process pre-authorisations for in-patient treatment for Compensation for Occupational Injuries and Diseases Act (COIDA) accidents.

**WHAT WILL YOU DO?**
- Generate the preauthorisation and feedback to Medical Service Provider (MSP) timeously
- Generate the hospital preauthorisation and feedback to MSP timeously
- Generate preauthorisation for Chronic medication for non-pensioners and supply feedback to MSP
- Authorise all Devices as per approval
- Ensure that all mandatory tariff codes are captured on authorisation
- Follow up on outstanding authorisation documents with Medical Service Providers
- Review and updating of ICD10 codes
- Preauthorisation of medical treatment in line with internal policies and Standard Operating Procedures
- Submission of daily, weekly, and monthly reports to Management
- Undertake relevant training as identified by line manager
- Adherence to Company Policies and Standard Operating Procedures
- Resolution of queries and complaints from stakeholders
- Participation in Company projects as and when requested
- Physio, Occupational Therapy and X-Rays
- Consultations, day procedures and corneal transplants
- Acute and chronic cases
- Assist with re-opening requests.
- Ad-hoc duties

**WHAT YOU'LL BRING TO THE TABLE?**
- Diploma or Degree in Nursing or related field
- Minimum of 4 years nursing/medical aid environment experience
- Registration with nursing council and related
- Contributing to Team Success
- Decision Making
- Work Standards
- Applied Learning
- Managing work and time management
- Stress tolerance
- Nursing Protocol
- Negotiation skills
- Communication skills
- Customer centric

**WHAT WILL YOU GET IN RETURN?**

We offer great opportunities for personal and professional development in a stable company that’s 128 years strong. The role comes with a competitive salary package and various benefits. Flexible work arrangements (combination of remote and in the office). Furthermore, you will be a part of a dedicated group of colleagues who value teamwork and collaboration.

**Turnaround time**

**Closing date: 5 April 2023**

**Our Commitment to transformation**:

- Diploma or Degree in Nursing or related field
- Minimum of 4 years nursing/medical aid environment experience
- Registration with nursing council and related
- Contributing to Team Success
- Decision Making
- Work Standards
- Applied Learning
- Managing work and time management
- Stress tolerance
- Nursing Protocol
- Negotiation skills
- Communication skills
- Customer centric