Clinical Hospital Auditor - Pretoria
R
320k
per annum
Pretoria, Gauteng
Pretoria,
Gauteng
more than 14 days ago
15-06-2015 10:04:40 PM
13-07-2015 10:04:40 PM
Clinical hospital auditor with experience required for established company.
Responsibility:
Auditing of hospital accounts
Negotiations with hospitals regarding disputes and guidelines
Updating of the hospital audit guidelines
Constant and continious gaining of experience and knowledge to ensure client satisfaction
Delivering a cost-effective managed healthcare service
Minimum Requirements:
BCur Degree/ Diploma in Nursing
Minimum 1-3 years experience within a medical aid in similar role
Medical Scheme – related experience in Hospital Benefit Management
ICU or theatre experience
Claims assessing experience
Thorough, well-grounded clinical knowledge of Pre Authorization of hospital admissions and Case Management of hospital cases in order to take cost-effective and appropriate decisions in evaluating treatment, LOS and LOC
Knowledge of the current coding structures in the South African Health Care environment i.e. ICD10’s, CPT4, NRPL, and PMB conditions, protocols and Scheme rules
Salary:
R 320k ctc per annum incl benefits