a Medical Claims Clinical Auditor to join their team based in Port Elizabeth - on a 6 month fixed term LOC/ LOS / item or drug approval queries to case managers for resolution. Act as clinical support to non-clinical of tariff and refer discrepancies to the relevant team. Review retrospective claim approvals and send journal instructions for additional payments to the relevant team. Review hospital claims for clinical appropriateness timeous feedback. Escalate queries to the relevant team or stakeholder. Provide accurate information and
a Medical Claims Clinical Auditor to join their team based in Port Elizabeth - on a 6 month fixed term LOC/ LOS / item or drug approval queries to case managers for resolution. Act as clinical support to non-clinical of tariff and refer discrepancies to the relevant team. Review retrospective claim approvals and send journal instructions for additional payments to the relevant team. Review hospital claims for clinical appropriateness timeous feedback. Escalate queries to the relevant team or stakeholder. Provide accurate information and