Description:
Key Responsibilities:
Analyse IOD claims to verify medical expenses and identify potential recoveries Submit and monitor IOD claims with SAPS and relevant administrators Prepare detailed reports on claims trends, recovery tracking, and issue escalation Ensure all information is verified, completed, and submitted accurately and on time Maintain relationships with SAPS, members, providers, and administratorsRequirements:
NQF Level 7 Nursing Qualification SANC Registration 4+ years of experience in:Medical Third Party Claims Administration Services Case Management in medical schemes Experience in ICD10/CPT coding Proven ability to manage third-party processes and resolve escalations
Skills & Competencies:
Claims and recoveries management SAPS liaison and provider engagement Report writing, auditing, and case analysis Strong ethics, compliance, and governance focus Collaboration, communication, and accountability
16 Jul 2025;
from:
gumtree.co.za