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