Main Job Functions: - Ensure collection of all debtors happens within relevant parameters. - Follow up with debtors on payments. - Ensure all invoices are paid timeously. - Follow up on queries. - Attend department meeting weekly to give feedback on age analysis. - Escalate any account problems to relevant department Managers. - Accurately monitor all outstanding funds and follow up. -...
Requirements: - Enrolled Nurse / Paramedic - 35 years of experience in pre-authorization within managed healthcare. - Knowledge of PMB conditions, clinical guidelines, ICD-10 codes, and hospital systems. - Familiarity with medical scheme regulations and billing procedures. Key Responsibilities: - Authorize hospital admissions per scheme guidelines. - Verify in-hospital benefits and funding. -...
Medical Billing Claims Administrator Location: Mooikloof, Pretoria East Salary: Market Related Specialisation: Specialist Medical Billing (Private Practice & Bureau) About the Opportunity A well-established Medical Bureau based in Pretoria East is looking for a Medical Billing Claims Administrator with recent, hands-on experience in specialist billing. This role is ideal for someone who...
MINIMUM REQUIREMENTS: · B.Eng degree (electronic or computer). · Software design and implementation experience (Minimum 10 years). · Experience in product development. · Software system engineering experience. · Specialist knowledge (required / preferred): o Object orientated programming experience (C++) (required). o Embedded systems software development (required). o Experience in image...
ENVIRONMENT: A leading provider of Electronic Systems seeks the technical expertise of an Automation and DevOps Engineer who can understand complex systems and break down requirements into manageable components. The ideal candidate for this role will have the strategic combination of the business analysis and software automation skills: critically observing and researching business processes and...
Position Overview: The successful candidate will be responsible collecting, analysing and interpreting complex healthcare data to support clinical, operational and strategic decision-making. The role requires strong technical expertise in SQL, data visualisation tools such as Power BI (or similar) and knowledge of clinical coding standards. Essential Job Functions: - Extract, manipulate and...
Overview Hire Resolve’s are seeking a detail-oriented and organized individual to join their medical billing team as a Medical Billing Agent. The ideal candidate will be responsible for accurately billing and collecting payments from patients and insurance companies. Key Responsibilities: Patient data capturin Billing for a variety of Specialist Doctors, Allieds, GP’s Have expert knowledge of...
Thank you for your interest in joining Solventum. Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people are at the heart of every innovation we pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best minds in healthcare to address our...
We're looking for an analytical, detail-oriented Consultants within the Hospital Benefit Management team . The role involves managing telephonic hospital pre-authorisations, clinical queries, and case management while building strong relationships with our members. Requirements: - Clinical Medical Associate qualification or Registered Nurse qualification - 1–2 years' Pre-Auth experience...
The key responsibility will be liaison between the patients and medical aid companies, ensure that correct coding (ICD & CPT) is used, authority received for LOS and monitoring of patients costs to ensure the hospital receive payment for services rendered. Requirements:General Nursing Diploma and SANC registeredMinimum of 3 years working experience as General Case ManagerGood knowledge of ICD...
Job Advert Summary:Minimum Requirements: - Grade 12 - Tertiary Qualification Experience- Medical Scheme Administration Experience 2 years essential- Assessing experience 2 years plus essential- Extensive understanding of the Administration System essential- Knowledge of Reference Price List essential- In-depth knowledge of Medical Scheme Rules essential- MS Office- Medical Scheme Act essential-...
Billing controller must have experience working with medical claims, ICD 10 and procedure codes. Must have GoodX experience. Person must have experience with IOD claims and Compeasy website. Salary: From R15,000.00 per month Ability to commute/relocate: - Pretoria, Gauteng: Reliably commute or planning to relocate before starting work (required) Experience: - Medical Billing / Medical...
Duties & Responsibilities: - Sales (converting door-to-door engagements, cold calling, networking and existing leads to business) - Software demonstration - Installation and client training - Perform client needs analysis - Package upgrades - Customer care - Client on-boarding - Meeting periodic quotas - Pipeline reports - General admin and filling Requirements: - At least 1 year of experience...
We are looking for a Clinical Research Specialist with the following key knowledge areas: - Basic understanding of evidence-based medicine. - Knowledge of health data standards. - Knowledge of “managed healthcare” or financial risk assessment principles (environment). - Knowledge of standards within the health industry. - Knowledge of the legislation governing company, policies and procedures. -...
To plan, coordinate and execute case management work at hospital level. The incumbent utilises clinical knowledge to minimise financial risk and ensure accurate billing through comprehensive accurate coding of patient care. Minimum Requirements: - Diploma in Nursing - 5 years’ experience as a hospital Case Manager - Technical Knowledge of ICD-10 and CPT Coding - Advance Certification in...
Overview St. John's Riverside Hospital is a leader in providing the highest quality, compassionate health care utilizing the latest, state-of-the-art medical technology. Serving the Westchester community from Yonkers to the river town communities of Hastings-on-Hudson, Ardsley, Dobbs Ferry and Irvington, St. John's Riverside has been and continues to be a unique and comprehensive network of...
A reputable Medical Aid is seeking an Administrator to join their PMB team. Job purpose: - Administration of PMB and CDL treatment plan authorisations. Requirements: - Grade 12 / Matric - 1 - 3 years' experience working in a Medical Aid environment using Administrative systems - Fair knowledge of the Medical Schemes Act, PMB legislation, ICD -10 and CPT coding - An understanding of technical...
Job Advert Summary:The Chief Information Officer (CIO) is responsible for leading the organization's information technology strategy, ensuring alignment with business objectives to enhance member experiences, drive innovation, and maintain compliance with regulatory requirements. The CIO will oversee the development and implementation of secure, scalable, and efficient IT systems that support...
Overview Hire Resolve has partnered with a Medical Billing company that provides medical practitioners with a range of medical account administration to find a Billing Agent Expert Leader to join their team in Johannesburg. Responsibilities Patient data capturing Patient Billing for a variety of Specialist Doctors, Allieds, GP’s Have expert knowledge on charge codes and ICD10 codes for all...
Duties & Responsibilities:Software Installation: - Install and configure the software at client practices, both onsite and remotely, ensuring smooth and efficient deployment. - Troubleshoot installation issues and provide technical support as needed during the setup process. Client Training: - Conduct detailed training sessions for clients, focusing on how to use the system effectively in...