Clinical Auditor
Posted on 2025-03-03
| Salary | 540000 Annually |
|---|---|
| Category | Accounting Finance |
| Location | Gauteng / Johannesburg |
Job Summary
Requirements:
Qualifications: Nursing diploma (registered or enrolled nurse). Experience: 3-5 years in clinical auditing or claims assessment within managed healthcare. Technical Knowledge: Medical coding (ICD-10, CPT), hospital tariffs, billing rules, reconciliation of claims, and familiarity with IMED/Cubed systems. Skills: Attention to detail, analytical thinking, professional communication, computer literacy, and numeracy. Key
Responsibilities:
Audit hospital accounts in accordance with billing regulations and clinical guidelines. Identify non-chargeable items and overcharges. Ensure hospital accounts align with authorizations on the system. Investigate and resolve claims discrepancies. Reconcile hospital accounts and liaise with external auditors on payment queries. Negotiate discounts and credits with hospitals. Capture and edit authorizations in the IMED system. Provide clinical expertise and training within the organization. Generate and submit weekly reports. Handle queries from hospitals and members regarding claims and payments.
Clinical Auditor position available in Gauteng, Johannesburg. This job position was posted by . The job has been posted on 2025-03-03 in the Accounting Finance category
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