DUE: 12 OCT 2023
Main Job Purpose
- Checks for completeness of registration documents in line with Cimas provider registration requirements.
- Maintains provider register by accurately capturing of any amendments and updates.
- Resolves provider queries in the region.
- Conducts provider training of new and existing service providers.
- Identifies provider training gaps in liaison with claims department and data analysis reports.
- Conducts bookkeeper’s courses for providers throughout the region in liaison with Public Relations Department and the Provider Liaison Coordinator
- Prepares the training content and material for approval by the Provider Liaison Co-ordinator.
- Schedules the training calendar in liaison with service providers.
- Reviews claiming patterns for newly registered providers and intervene accordingly.
- Adjudicates injury related claims and refers work related injury/illness claims to Forensic Department.
- Recommends investigation and possible suspension of providers in liaison with Forensic Department.
- Compiles and produces reports on provider registration and training.
- Complies register of service provider queries and resolutions statistics in line with set standards
- Degree in Nursing/Health Sciences or the equivalent.
- At least 2 years’ experience in a medical aid or hospital environment adjudicating claims & billing.
- Clinical procedures knowledge is essential.
- Good verbal and written communication skills and ability to prepare accurate reports.
- Ability to plan and organise in line with job requirements.
- Ability to analyse and solve work related problems while achieving the right outcome simultaneously.
- Excellent time management and teamwork skills.
If you are interested and you meet the stipulated requirements, please submit your letter of motivation and CV to this email firstname.lastname@example.org no later than Wednesday 12 October 2023.
Clearly highlight the position applied for in the email subject.