Marie Stopes Clinics Jobs in South Africa
Medical Claims Clinical Auditor (ee)
Headhunters
South Africa
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)
share this job on whatsappMedical Claims Clinical Auditor (ee)
Port Elizabeth
Monthly nursing experience.
- Apply scheme rules, clinical policies and protocols to funding.
- Action 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) relevant team.
- Review hospital claims for clinical appropriateness, treatment authorized, over-usage
Clinical Risk Management Specialist (cape Town) Market Related
Mvg Recruitment SpecialistsCape Town Region
Clinical Risk Management Specialist Industry: Insurance Location: Cape Town Type: Hybrid (3 In/ 2 Out) seeks to employ a Clinically qualified individual to assist within their Clinical Risk Management team with clients to address risk profiles. Provide clinical leadership and support. Analyze research data the relevant council. Proven underwriting and clinical risk management working experience within Managed
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