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 allocated hospital claims for audit within department KPIs and CMS requirements for claims payment. Ensure case managers for resolution. Act as clinical support to non-clinical hospital claim auditors in terms of
employ a Client Services Manager: Occupational Health Nurse based in Port Elizabeth. A wonderful career is essential. Degree / Diploma in Occupational Health Nursing is essential. Certificates in Audiology Occupational Health Practitioner. Minimum of 3 - 5 years' experience in an Occupational Health Nurse leadership of standard operating practices in Occupational Health. MS Office / Office 365 proficiency. Registration with the South African Society of Occupational Health Nurses (SASOHN) is preferred. It is essential to
employ a Client Services Manager: Occupational Health Nurse based in Port Elizabeth. A wonderful career is essential. Degree / Diploma in Occupational Health Nursing is essential. Certificates in Audiology Occupational Health Practitioner. Minimum of 3 - 5 years' experience in an Occupational Health Nurse leadership of standard operating practices in Occupational Health. MS Office / Office 365 proficiency. Registration with the South African Society of Occupational Health Nurses (SASOHN) is preferred. It is essential to
cost-effective managed health care with the objective of promoting rational utilization of health care facilities Nursing Diploma or Degree. Minimum of 2 years clinical experience within a private hospital is essential level of care. Liaise with the service provider on clinical updates, as well as outstanding information. Engage implement and communicate the practice and/or clinical guidelines for cost effective care. Authorize and escalate accordingly. Provide clinical support to non-clinical team's if/when required. Drive and
cost-effective managed health care with the objective of promoting rational utilization of health care facilities Nursing Diploma or Degree. Minimum of 2 years clinical experience within a private hospital is essential level of care. Liaise with the service provider on clinical updates, as well as outstanding information. Engage implement and communicate the practice and/or clinical guidelines for cost effective care. Authorize and escalate accordingly. Provide clinical support to non-clinical team's if/when required. Drive and
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 allocated hospital claims for audit within department KPIs and CMS requirements for claims payment. Ensure case managers for resolution. Act as clinical support to non-clinical hospital claim auditors in terms of
RFQ's and provide this information to the Costing Department. Packaging and dunnage design, customer liaison close-out. Conduct Housekeeping, Environmental and Health & Safety observation tours as scheduled. Daily levels of efficiency and professionalism within department. Kindly be advised that should you not receive
Ensures open communication channels with relevant Departments to ensure highest standards of product quality or areas of concern to management within own department and area of Responsibility. Ensures compliance complies with and assumes responsibility for enforcing Health, Safety and Environmental legislation, regulation
Responsibilities and expectations but not limited to: Health & Safety: Compliance with all EH & S guidelines continuous improvement. Interaction with all other departments (technical, quality) and sites in group for problem
Provide support to operational departments and other support departments, this includes assisting project