Cape Town: Clinical Auditor posted by SD Recruitment (Pty) Ltd

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Job Summary

Skills: 

• Teamwork 
• Examining information 
• Articulating information 
• Upholding standards 
• Accountability 
• Attention to detail 
• Time management 

Internal Process 

• Apply clinical policies and protocols to funding. 
• Ensure accurate notes are made for all clinical audits as well as claims. 
• Ensure accurate completion of authorizations on audit finalization. 
• Refer approval queries to department managers for resolution. 
• Act as clinical support to non-clinical hospital clinical auditors in terms of hospital tariff applications and clinical guidance. 
• Ensure correct application of tariff and discrepancies are forwarded to the relevant team. 
• Review hospital dues for clinical appropriateness, treatment authorized, over-usage of equipment/materials. 

 
Customer Service 

• Investigate hospital queries within the agreed service level and ensure that the relevant stakeholder receives timeous feedback. 
• Escalate queries to the relevant team or stakeholder. 
• Provide accurate information and advice to stakeholders to ensure that they receive the appropriate service. 
• Resolve auditing queries accurately and timeously. 
• Build and maintain relationships with internal and external stakeholders. 

 People: 

• Continuously develop own expertise in terms of industry and subject matter development and application thereof in an area of specialization. 
• Contribute to continuous innovation through the development, sharing and implementation of new ideas and involvement of colleagues and staff. 
• Participate and contribute to a culture of work centric thinking, productivity, service delivery and quality management. 
• Provide input into the risk identification processes and communicate recommendations in the appropriate forum.

Finance

• Identify opportunities to enhance cost effectiveness and increase operational efficiency 
• Manage financial and other company resources under your control with due respect

Requirements 

• A National Senior Certificate isessential. 
• It isessentialto have a Nursing Diploma or Degree. 
• The incumbentmustbe registered with the South African Nursing Council (SANC) as aRegistered Nurse.  
• Minimumof 2 years’privatehospital nursing experience. 
• Previous exposure to clinical auditing is highlyuseful. 
• Be available to work on site. 

Clinical Auditor position available in Western Cape, Cape Town. This job position was posted by SD Recruitment (Pty) Ltd. The job has been posted as a char8000 ad on 2024-06-15 at 01:02:47 in the Medical category

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