Claims Auditor

A well-established company is recruiting for aCLINICAL AUDITOR: HOSPITAL CLAIMSBRYANSTONPURPOSE OF THE JOBThe purpose of the role is to ensure that members get proper and appropriate medical treatment in accordance with the billing guidelines, while also protecting members' funds by ensuring that there is no abuse by members or providers. Ensure that all the...

A well-established company is recruiting for aCLINICAL AUDITOR: HOSPITAL CLAIMSBRYANSTONPURPOSE OF THE JOBThe purpose of the role is to ensure that members get proper and appropriate medical treatment in accordance with the billing guidelines, while also protecting members' funds by ensuring that there is no abuse by members or providers. Ensure that all the...

A leading educational institution, Middlesex College, is seeking a seasoned professional to fill the role of Clinical Auditor - Hospital Claims.Job DescriptionThe purpose of this position is to ensure that healthcare members receive appropriate medical treatment in accordance with billing guidelines while protecting their funds from potential abuse. The...

**Introduction** Audit and monitor Binder Agreements as per audit programme. **Role Purpose** Audit and monitor Binder Agreements as per audit programme. **Requirements**: - Matric - FAIS compliant - An insurance/ relevant qualification - At least 5-10 years relevant working experience, with some supervisory functions - A comprehensive understanding of...

About the Role:This is a challenging role that requires a skilled clinical auditor to work closely with healthcare providers to ensure accurate and efficient claim processing. The ideal candidate will have a strong background in nursing and clinical auditing, with experience in ICD10 coding and medical aid industry knowledge.

**Introduction** - To assist with the claims audit process and ongoing monitoring on Outsource, Broker Binder Business Partners and UMA’s. **Disclaimer** - As an applicant, please verify the legitimacy of this job advert on our company career page. **Role Purpose** - To assist with the claims audit process and ongoing monitoring on Outsource, Broker...

Job Description:The clinical auditor will ensure that all claims and duties are performed within the agreed service levels with providers. This involves efficiently and accurately processing claims, vetting accounts under guidance, using clinical guidelines and protocols, and daily auditing of captured accounts.Main Responsibilities:Vet hospital accounts...

Job Summary:We are seeking an experienced clinical auditor to join our team at Middlesex College. As a clinical auditor, you will be responsible for ensuring the accuracy and efficiency of claim processing, working closely with healthcare providers to achieve this goal.Main Duties:Vet hospital accounts under the guidance of the gazetteUse clinical guidelines...

About the Job:This is an exciting opportunity for a skilled clinical auditor to join our team at Middlesex College. As a clinical auditor, you will play a critical role in ensuring the accuracy and efficiency of claim processing, working closely with healthcare providers to achieve this goal.Main Responsibilities:Clinical auditing of hospital accountsVetting...

Ensuring that all claims and duties are performed within the agreed service levels with providers and that claims are efficiently and accurately processed.Vet hospital accounts under the guidance of the gazette.Use clinical guidelines and protocols when vetting accounts.Daily auditing of captured accounts.Align hospital accounts with authorisations on the...

**MAIN RESPONSIBILITIES & JOB REQUIREMENTS** - Conduct audits from planning to completion, including visiting client premises, reviewing client documentation, and communicating with clients. - Preparation of the annual financial statements within the required framework. - Preparation of taxation calculations for clients. - Verification of client information...

**Introduction** The Underwriter will be responsible for writing new business, providing renewal terms, technical and claims advice, and liaising with brokers within the agreed mandate limits as determined by the Product Manager / Underwriting Executive. **Role Purpose** The Underwriter will be responsible for writing new business, providing renewal...

**Introduction** To structure and seek optimum reinsurance solutions for the company and our clients. **Role Purpose** To structure and seek optimum reinsurance solutions for the company and our clients. **Requirements**: - Matric /Grade 12 - Relevant Degree and/ or Insurance qualification - Experience, in the short-term reinsurance industry is...

-Introduction The Underwriter will be responsible for writing new business, providing renewal terms, technical and claims advice, and liaising with brokers within the agreed mandate limits as determined by the Product Manager / Underwriting Executive. Role Purpose The Underwriter will be responsible for writing new business, providing renewal terms,...

**Introduction** - The Underwriter will be responsible for writing new business, providing renewal terms, technical and claims advice, and liaising with brokers within the agreed mandate limits as determined by the Product Manager / Underwriting Executive.**Disclaimer** - As an applicant, please verify the legitimacy of this job advert on our company career...

To conduct payroll administration for all CHG employees (full time and agency) and to ensure the accuracy of payroll-related information of all employees and potential recruits. The incumbent liaises between CHG Head Office and Hospitals to ensure the accuracy of payroll reporting, processing and adherence to relevant RSA legislation. **Minimum...

**Introduction** - The Underwriter will be responsible for writing new business, providing renewal terms, technical and claims advice, and liaising with brokers within the agreed mandate limits as determined by the Product Manager / Underwriting Executive.**Role Purpose** - The Underwriter will be responsible for writing new business, providing renewal...

**Key Performance area**: **1.** **Ensure compliance and governance of Health and Safety regulations.** - Conduct safety inspections and audits on a frequent and regular basis. - Compile risk assessments annually. - Conduct regular Fire Prevention inspections. - Ensure all safety signs and notices are prominently displayed at all sites. - Ensure machinery is...

A well known short term insurance company based in Sandton is looking for a Head of Business Intelligence **Purpose of the job**: The Head of Business Intelligence plays a key role in ensuring that the company is, at all times, fully apprised of the external risks that could impact the underwriting profit and solvency of the business. The Head of Business...

A well known short term insurance company based in Sandton is looking for a Head of Business Intelligence **Purpose of the job**: The Head of Business Intelligence plays a key role in ensuring that the company is, at all times, fully apprised of the external risks that could impact the underwriting profit and solvency of the business. The Head of Business...