Junior Clinical Assistant PMB Location: Pretoria Salary: Market related Ref: JCAPMB/BM/TB Medical Aid
Company Top Medical Aid company in SA striving to be 1 Purpose Administration of PMB and CDL treatment plan authorisations. Preparation, referral and finalisation of PMB applications for members in and out of hospital. Responsibilities Approval of referred PMB applications. Management of PMB referra
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)
commercially viable clinic through the promotion and delivery of professional, value-adding clinic services in client base through effective promotion of the Clinic's services to Clicks' customers and by delivering and customer service To provide a multitude of clinic services, including but not limited to, providing management screening tests, conducting ‘well baby' clinics, health immunisations, baby health monitoring, rendered To ensure the efficient running of the clinic through effective administration, booking of locums
commercially viable clinic through the promotion and delivery of professional, value-adding clinic services in client base through effective promotion of the Clinic's services to Clicks' customers and by delivering and customer service To provide a multitude of clinic services, including but not limited to, providing management screening tests, conducting ‘well baby' clinics, health immunisations, baby health monitoring, rendered To ensure the efficient running of the clinic through effective administration, booking of locums
utilisation management, education/training, and other clinically based activities as assigned, to coordinate care Communicates with the admitting facility to establish the clinical status of the patient. • Communicates updates stay and value to the hospital subject to the clinical guidelines and protocols of the company. • Communicates Updates the computer system with the member's clinical and demographic details. • Visits high cost members participates in discussions and presents cases at clinical meetings. • Prepares reports and case summaries
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)
deliver professional, commercially viable and quality clinic services in compliance with South African Nursing company standards. â–ª Manage a commercially viable clinic in line with company guidelines â–ª Provide lifestyle management screening tests â–ª Conduct “Well Baby” clinics, including health immunisations and baby health and reporting to ensure efficient running of the clinic as per company policy and processes â–ª Ensures and adhered to â–ª Manages, monitors and orders clinic services stock and equipment, along with prevention
deliver professional, commercially viable and quality clinic services in compliance with South African Nursing company standards. â–ª Manage a commercially viable clinic in line with company guidelines â–ª Provide lifestyle management screening tests â–ª Conduct “Well Baby” clinics, including health immunisations and baby health and reporting to ensure efficient running of the clinic as per company policy and processes â–ª Ensures and adhered to â–ª Manages, monitors and orders clinic services stock and equipment, along with prevention
of counselling and referrals Compiling monthly clinic reports Matric Professional Nursing Qualification Licence (a must) Computer Literacy (Knowledge of Clinic Sister would be an advantage) 5 years related experience