limited to: INTERNAL PROCESS Apply scheme rules, clinical policies and protocols to funding. Action allocated case managers for resolution. Act as clinical support to non-clinical hospital claim auditors in terms of of hospital tariff applications and clinical guidance (e.g. procedures, devices and drug utilisation) the relevant team. Review hospital claims for clinical appropriateness, treatment authorised, over-usage hospital nursing experience Previous exposure to clinical auditing is highly advantageous. IMPORTANT ATTRIBUTES
limited to: INTERNAL PROCESS Apply scheme rules, clinical policies and protocols to funding. Action allocated case managers for resolution. Act as clinical support to non-clinical hospital claim auditors in terms of of hospital tariff applications and clinical guidance (e.g. procedures, devices and drug utilisation) the relevant team. Review hospital claims for clinical appropriateness, treatment authorised, over-usage hospital nursing experience Previous exposure to clinical auditing is highly advantageous. IMPORTANT ATTRIBUTES
nursing experience.
medical insurance space is seeking a Medical Claims Clinical Auditor to join their team based in Port Elizabeth hospital nursing experience. Previous exposure to clinical auditing is highly advantageous. Be available Responsibilities INTERNAL PROCESS Apply scheme rules, clinical policies and protocols to funding. Action allocated case managers for resolution. Act as clinical support to non-clinical hospital claim auditors in terms of of hospital tariff applications and clinical guidance (e.g. procedures, devices and drug utilization)
Investigators in coordinating all aspects of Clinical Trials, including clinic management, staffing, data collection within the projects
medical insurance space is seeking a Medical Claims Clinical Auditor to join their team based in Port Elizabeth hospital nursing experience. Previous exposure to clinical auditing is highly advantageous. Be available Responsibilities INTERNAL PROCESS Apply scheme rules, clinical policies and protocols to funding. Action allocated case managers for resolution. Act as clinical support to non-clinical hospital claim auditors in terms of of hospital tariff applications and clinical guidance (e.g. procedures, devices and drug utilization)
Diploma or Degree.
Nursing Diploma or Degree. Minimum of 2 years clinical experience within a private hospital is essential level of care. Liaise with the service provider on clinical updates, as well as outstanding information. Engage implement and communicate the practice and/or clinical guidelines for cost effective care. Authorize and escalate accordingly. Provide clinical support to non-clinical team's if/when required. Drive and
Nursing Diploma or Degree. Minimum of 2 years clinical experience within a private hospital is essential level of care. Liaise with the service provider on clinical updates, as well as outstanding information. Engage implement and communicate the practice and/or clinical guidelines for cost effective care. Authorize and escalate accordingly. Provide clinical support to non-clinical team's if/when required. Drive and
negotiating annual increases for clients.