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)
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)