Our client is a leading medical scheme based in Pretoria, dedicated to providing comprehensive healthcare seeking a dedicated and experienced Claims Assessor to ensure that all claims are assessed accurately and paid of 2 years of claims assessing experience in the Medical Aid industry. Assess all claims using the appropriate Ensure accurate and timely processing of claims. Verify claim details and documentation for accuracy and healthcare providers and members to resolve any claim-related queries or issues. Adhere to the clients
Our client is a leading medical scheme based in Pretoria, dedicated to providing comprehensive healthcare seeking a dedicated and experienced Claims Assessor to ensure that all claims are assessed accurately and paid of 2 years of claims assessing experience in the Medical Aid industry. Assess all claims using the appropriate Ensure accurate and timely processing of claims. Verify claim details and documentation for accuracy and healthcare providers and members to resolve any claim-related queries or issues. Adhere to the clients
our client in Pretoria, we are recruiting for a Medical Pre-Authorisation Consultant. The ideal candidate summary of the members' clinical history for the medical advisor. Monitor the flow of documents between between the pre-authorisation division and the medical advisor. Approve benefits accurately according to the the following: Comprehensive knowledge of the Medical Scheme Act; Sound knowledge of CPT-4, ICD-10 and
Provide clinical interpretation and analysis of medical reports and doctor's motivations. Information Dissemination: Knowledge: Comprehensive understanding of the Medical Schemes Act. Coding Proficiency: Sound knowledge
impacting financial services providers, including the Medical Schemes Act and FAIS legislation Strong understanding
impacting financial services providers, including the Medical Schemes Act and FAIS legislation Strong understanding