Clinical Claims Auditor

Found in: Talent ZA C2 - 3 weeks ago


Cape Town, South Africa Mednurse Full time

A vacancy exists in our clients Clinical division. The position offered will suit a self-motivated and?driven person who will be assisting in the auditing of risk claims, in and out of hospital.

Your duties will include but not be limited to the following:

Auditing of accounts, applying industry rules and guidelines as set out in the relevant Tariff and Billing Rules, with outstanding administration skills.

 

The following competencies are required:

  • Attention to detail with and investigative mind
  • Self-motivated
  • Confident with strong inter-personal skills
  • Strong administrative skills
  • Strong verbal and written communication
  • Strong organizational skills with the ability to multi-task

 

The following minimum qualifications are required:

  • Nursing Qualification (RN)
  • Experience in Medical and Surgical field
  • Exceptional understanding of tariff schedules and Hospital/Doctor billing guidelines?
  • Knowledge of ICD10 and CPT4 coding
  • Basic knowledge of Medical Terminology 

  • Senior Clinic Administrator

    Found in: Talent ZA 2A C2 - 3 weeks ago


    Cape Town, South Africa SA Metal Full time

    SENIOR CLINIC ADMINISTRATOR: EPPING The Company Clinic currently has a vacancy for an experienced, attentive to detail and, efficient individual to join their team. The successful candidate should have sufficient understanding of all administrative procedures required in order to ensure the smooth operational running of the clinic. Duties and...

  • Senior Clinic Administrator

    Found in: Whatjobs ZA C2 - 1 week ago


    Cape Town, South Africa SA Metal Full time

    SENIOR CLINIC ADMINISTRATOR: EPPING The Company Clinic currently has a vacancy for an experienced, attentive to detail and, efficient individual to join their team. The successful candidate should have sufficient understanding of all administrative procedures required in order to ensure the smooth operational running of the clinic. Duties and...

  • Manager: Claims

    5 days ago


    Cape Town, South Africa Momentum Metropolitan Holdings Full time

    -Introduction Role Purpose To oversee and take accountability for key Claims functions and as a result ensure that MHC continues to efficiently and effectively provide leading administrative services to the Scheme and its members. Further to this, ensure standardisation, consistency and optimisation of processes across claims administration. Requirements -...

  • Senior Clinic Administrator

    Found in: Talent ZA C2 - 3 weeks ago


    Cape Town, South Africa SA Metal Group (Pty) Ltd Full time

    SENIOR CLINIC ADMINISTRATOR: EPPING The Company Clinic currently has a vacancy for an experienced, attentive to detail and, efficient individual to join their team. The successful candidate should have sufficient understanding of all administrative procedures required in order to ensure the smooth operational running of the clinic. Duties and...

  • Clinical Risk Management Administrator

    Found in: beBee jobs ZA - 2 weeks ago


    Cape Town, Western Cape, South Africa MHR Full time

    MHR's job vacancy, Career and RecruitmentJob title : Clinical Risk Management Administrator – Cape Town jobs in Western CapeJob Location : Western Cape, Cape TownDeadline : May 06, 2024Quick Recommended LinksJobs by LocationJob by industries Introduction MHR is currently recruiting for a Clinical Risk Management Administrator position at a dynamic...

  • Internal Auditor

    5 days ago


    Cape Town, South Africa Immploy Recruitment Full time

    **Key Outputs**: Assess, evaluate, and monitor the adequacy, effectiveness and efficiency of the organizations internal control systems. Identify improvements and enhancements to the internal control systems. Risk Management - Identify risk areas and implement controls and systems to address these. Investigate breaches of internal controls. Review...

  • Clinical Risk Management Administrator

    Found in: beBee S ZA - 3 weeks ago


    Western Cape, Cape Town, South Africa MHR Full time

    MHR’s job vacancy, Career and Recruitment Job title : Clinical Risk Management Administrator – Cape Town jobs in Western Cape Job Location : Western Cape, Cape Town Deadline : May 06, 2024 Quick Recommended Links Jobs by Location Job by industries Introduction     MHR is currently recruiting for a Clinical Risk Management Administrator position...


  • Cape Town, South Africa Health Solutions Full time

    **Introduction** Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable,integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build andmaintain a culture of innovation,and create value through unique insights of how to achieve specific outcomes by...


  • Cape Town, South Africa Mednurse Full time

    Assess, evaluate, and monitor the adequacy, effectiveness and efficiency of the organizations internal control systems. - Identify improvements and enhancements to the internal control systems. - Risk Management - Identify risk areas and implement controls and systems to address these. - Investigate breaches of internal controls. - Review policies and...

  • Private Hospital Internal Auditor

    Found in: Talent ZA 2A C2 - 5 days ago


    Cape Town, South Africa Mednurse Full time

    • Assess, evaluate, and monitor the adequacy, effectiveness and efficiency of the organizations internal control systems.• Identify improvements and enhancements to the internal control systems.• Risk Management - Identify risk areas and implement controls and systems to address these.• Investigate breaches of internal controls.• Review policies...

  • Private Hospital Internal Auditor

    Found in: Whatjobs ZA C2 - 5 days ago


    Cape Town, South Africa Mednurse Full time

    • Assess, evaluate, and monitor the adequacy, effectiveness and efficiency of the organizations internal control systems.• Identify improvements and enhancements to the internal control systems.• Risk Management - Identify risk areas and implement controls and systems to address these.• Investigate breaches of internal controls.• Review policies...

  • Private Hospital Internal Auditor

    Found in: Talent ZA C2 - 6 days ago


    Cape Town, South Africa Mednurse Full time

    • Assess, evaluate, and monitor the adequacy, effectiveness and efficiency of the organizations internal control systems.• Identify improvements and enhancements to the internal control systems.• Risk Management - Identify risk areas and implement controls and systems to address these.• Investigate breaches of internal controls.• Review policies...

  • Private Hospital Internal Auditor

    Found in: Adzuna ZA B C2 - 5 days ago


    Cape Town, South Africa Adzuna ZA B C2 Full time

    • Assess, evaluate, and monitor the adequacy, effectiveness and efficiency of the organizations internal control systems.• Identify improvements and enhancements to the internal control systems.• Risk Management - Identify risk areas and implement controls and systems to address these.• Investigate breaches of internal controls.• Review policies...

  • Senior Underwriter

    Found in: Talent ZA C2 - 1 week ago


    Cape Town, South Africa Old Mutual Full time

    Description Role Overview Use your specialist technical medical knowledge to assess risk for business and/or specific products. Uses specialist technical knowledge to evaluate and manage the validity of contracts and determine and manage the liability of claims (Assessor). Determines, selects and accepts risk and/or liability on behalf of the...

  • HIV Adherence Coordinator

    Found in: Talent ZA 2A C2 - 3 weeks ago


    Cape Town, South Africa Palesa Mbali Group Full time

    The HIV Adherence Coordinator educates and supports members with the aim of empowering them to manage their disease better, thereby improving their health outcomes and limiting healthcare costs whilst maintaining quality of care.Key Activities:Provide appropriate and impactful telephonic and written counselling, education and support to allocated clients...

  • HIV Adherence Coordinator

    Found in: Talent ZA C2 - 3 weeks ago


    Cape Town, South Africa Palesa Mbali Group Full time

    The HIV Adherence Coordinator educates and supports members with the aim of empowering them to manage their disease better, thereby improving their health outcomes and limiting healthcare costs whilst maintaining quality of care.Key Activities:Provide appropriate and impactful telephonic and written counselling, education and support to allocated clients...


  • Cape Town, South Africa Health Solutions Full time

    **Introduction** Metropolitan is one of the oldest financial services brands in South Africa. With a 116-year legacy of serving the communities in which it operates, Metropolitan represents true empowerment in serving Africa's people through affordable financial solutions that create financial growth and security. **Role Purpose** Accountable for Claims...

  • Food Safety Manager

    4 days ago


    Cape Town, South Africa RPO Recruitment Full time

    We are looking for a reliable Food Safety Manager to ensure everyone in the company complies with health and safety laws. You will also be responsible for establishing policies that will create and maintain a safe workplace. As a Food Safety Manager you must have excellent attention to detail to identify hazards. You will also be able to discover...


  • Cape Town, South Africa Discovery Ltd. Full time

    **Business Unit**:Discovery Health**Function**:Clinical**Date**:02-Jun-2023- Care Co-Ordinator- About Discovery - Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery. Our...

  • Counselor Mental Health Programme

    Found in: Talent ZA 2A C2 - 3 weeks ago


    Cape Town, South Africa Palesa Mbali Group Full time

    Position Name Counselor Mental Health ProgrammePosition PurposeTo educate and support members with the aim of empowering them to manage their disease better thereby improving their health outcomes and limiting healthcare costs whilst maintaining quality of care.Experience2-3 years hospital/clinic or managed care experience, providing...