Consultant Medical Management

4 days ago


East London, South Africa Jobted ZA C2 Full time

Qualifications and Experience:

- Bachelors Degree/Advanced Diploma in Health Sciences /Medical related qualification.
- Registration with HPCSA/SANCA
- Relevant 3 years experience in a Medical related environment
- Conduct medical assessment and compile injury assessment reports.
- Conduct assessments and bill reviews on submitted claims, focusing on the appropriate level of care, the length of stay, and quality of care.
- Escalation of complex cases for multi-disciplinary review and adjudication.
- Participate in the consultations process on the implementation of medical claims processes.

Technical Competencies:

- Claims management process/ processes and systems.
- Medical product management
- Medical bill reviewing
- Medical case management
- Complex problem identification, solving and decision making Customer value proposition
- Strong clinical analytical capabilities
- Knowledge of motor vehicle accident legislation
- Planning, Organising and Coordinating.
- Personal Mastery.
- Judgement and Decision Making.
- Ethics and Values.
- Client Service Orientation.

Please note that if you have not received a response within 14 days of submitting your application that your application was unsuccessful.



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