Clinical Claims Adjudicator

SUMMARY:
Preference will be given to EE candidates with 1st preference being African Males.

POSITION INFO:

Main Purposes

The incumbent will be responsible for effective and efficient adjudication of COIDA and Non-COID (diseases and accidents) i.e. ICD10 codes, Authorisation of treatment, Temporal Total Disability, claims estimates, Management of Claims Maximum Medical Improvement, Percentage Disability calculations and recommend Whole Person Impairment percentage, etc.

Minimum Requirements

• National Diploma in Nursing/Allied Health (physio therapist, occupational therapist)/related field with additional certification. It must be NQF6
• RE5 Certificate
• 4 years’ clinical and ICD10 coding experience is required
• COIDA Experience (Advantage)
• Medical Aid experience / life insurance claims environment experience is a must

Key Performance Indicators

• Claims processing and adjudication.
• Whole Person Impairment assessment.
• Attend to queries related to claims under management.

Only shortlisted candidates will be contacted. If you are not contacted within a month, please take your application as unsuccessful.

NB! This job is now closed. You can apply for other jobs by uploading your CV.