Medical Claims Auditor Role

Reference: PE002332-RW-1Our client operating in the medical insurance space is seeking a Medical Claims Clinical Auditor to join their team based in Port Elizabeth - on a 6 month fixed term contract.Nursing Diploma or Degree essentialEE candidate preference.An awesome career opportunity awaitsDuties & ResponsibilitiesRole PurposeThe purpose of this temporary...

Auditor in Clinical ServicesAbout the JobHire Power Recruitment is seeking an experienced Registered Nurse to join their team as a Clinical Auditor. This is a six-month fixed term contract opportunity with a competitive salary package.Main Responsibilities:Action hospital claims for audit within department KPIs and CMS requirements for claims payment.Perform...

Clinical Reviewer RoleAbout the OpportunityThis is an exciting opportunity for an experienced Registered Nurse to join our team as a Clinical Reviewer. The successful candidate will be responsible for reviewing hospital claims to ensure accuracy and compliance, as well as providing support to non-clinical staff in interpreting medical records and resolving...

This Medical Claim Validation Professional role at Headhunters involves ensuring that hospital claims are validated accurately and efficiently.ResponsibilitiesInvestigate hospital claim queries within the agreed service level and ensure that the relevant stakeholder receives timeous feedback.Resolve claim queries accurately and timeously.You will also be...

Job DescriptionWe are seeking an experienced Registered Nurse to fill the position of Clinical Auditor. As a Clinical Auditor, you will be responsible for ensuring that hospital claims are accurately processed and compliant with funding rules.The ideal candidate will have a strong background in private hospital nursing and experience in clinical auditing....

About the RoleWe are seeking a skilled Registered Nurse to fill the position of Clinical Auditor. As a Clinical Auditor, you will play a critical role in ensuring the accuracy and compliance of hospital claims.The ideal candidate will have a strong background in private hospital nursing and experience in clinical auditing. You will work closely with the team...

About the OpportunityWe are seeking a highly skilled Registered Nurse to fill the position of Clinical Auditor. As a Clinical Auditor, you will play a critical role in ensuring the accuracy and compliance of hospital claims.The ideal candidate will have a strong background in private hospital nursing and experience in clinical auditing. You will work closely...

Clinical Auditor (Registered Nurse)Reference: PE000173-HP -2The hiring organisation offers a minimum six-month fixed term contract opportunity to an experienced Registered Nurse with private hospital nursing experience.Ideally you will be based in Port Elizabeth, EC but the possibility exists of a candidate being based in Durban, Bellville or Centurion.ROLES...

About This RoleWe are seeking a highly skilled and experienced individual to fill the role of Medical Account Specialist. As a key member of our team, you will be responsible for managing the entire process of collecting and processing medical claims.This position requires exceptional organizational skills, attention to detail, and strong communication...

DescriptionOur client in the Insurance Industry is currently looking to employ a Professional Nurse: Clinical Auditor in Port Elizabeth.To ensure hospital claims are audited timeously and accurately with the focus on reducing wastage and abuse, as well as to ensure that claims are processed according to authorisations.A wonderful career opportunity awaits...

As a Clinical Insurance Auditor at Headhunters, you will be responsible for reviewing and processing hospital claims to ensure accuracy and efficiency.Job DescriptionApply scheme rules, clinical policies, and protocols to funding.Act as clinical support to non-clinical hospital claim auditors in terms of hospital tariff applications and clinical guidance.You...

Registered Nurse - Clinical AuditorReference: PE000173-HP -2The hiring organisation offers a minimum six-month fixed term contract opportunity to an experienced Registered Nurse with private hospital nursing experience. Ideally you will be based in Port Elizabeth, EC but the possibility exists of a candidate being based in Durban, Bellville or...

About the RoleWe are seeking an experienced Nursing Diploma or Degree holder to join our team as a Medical / Managed Care Claims Case Manager. This is a 6-month fixed-term contract based in Port Elizabeth.Main ResponsibilitiesManage and enhance cost-effective managed healthcare services.Conduct reviews of in-hospital patients for appropriateness of...

We are seeking a highly skilled Senior Auditor to join our team at Tower Group.Job Summary :The Senior Auditor will be responsible for leading and executing audit engagements, ensuring compliance with regulatory standards and client-specific requirements.About the Role :This role involves planning, executing, and finalizing audit assignments for a portfolio...

About YouWe're looking for a talented and experienced professional to join our team as a Customer Service Representative - Medical Accounts. If you possess excellent communication skills, a passion for delivering exceptional customer service, and a keen eye for detail, we'd love to hear from you.This role offers the perfect blend of administrative and...

Clinical Auditor PositionJob SummaryWe are seeking an experienced Registered Nurse to fill a Clinical Auditor position. This is a challenging role that requires strong analytical and problem-solving skills, as well as excellent communication and interpersonal skills.Key Accountabilities:Action hospital claims for audit within department KPIs and CMS...

Job DescriptionThe successful candidate will be responsible for the holistic management of medical practices' outstanding COIDA books combined with the management of collections for these books from the CF.Key Performance Areas:Medical Accounts AssessmentProcess all medical accounts for any batches received from the medical practice(s) allocated to employee...

Nurse in Industry PositionWe are seeking an experienced Nurse in Industry to provide comprehensive nursing services to our employees. As an integral member of our team, you will be responsible for conducting health assessments, developing and implementing health and safety programs, and delivering training sessions on various health-related topics.To succeed...

Job SummaryWe are seeking a highly skilled Insurance Claims Consultant to join our team at Ultimate Search Consultants. In this role, you will be responsible for managing claims from inception to settlement, ensuring that all policies and procedures are adhered to.Your key responsibilities will include administering claims, communicating with clients and...

Our client is seeking a Claims Consultant to join their team.The purpose of this role is to Administer all aspects relative to the preparation of Automotive Production Development Programme (APDP 2) claims, Duty Drawbacks (Item 521, 522, 536 and Tyre Levy claims), Form C2 and SMD certificates, EU and SADC declarations and any new product offeringsThis...