Tariffs and Risk Management Officer 264 views

The position is responsible for ensuring the timeous review and circulation of Tariffs to users, as well as ensuring the continuous capacity building for medical aid staff members and service providers staff members. The job also supervises accreditation activities and activities to reduce medical aid Fraud, Waste, Abuse Misuse or error .

Duties And Responsibilities

1. Handle tariff issues and timeously circulate tariffs where changes would have been made.

2. Capacity building for the Claims assessors, Service providers/hospitals’ billing staff

3. Supervising the Coordination of the activities of the Risk Management Committee

4. Overseeing the accreditation processes of institutions to ensure quick response promote quality.

5. Supervise to ensure routine re-inspections are carried out

Qualifications And Experience

Degree in Nursing Administration OR a Diploma in General

Nursing plus any Management or Administrative Qualification

or any other Degree. Working experience in medical aid claims

processing, investigations, healthcare forensics or in a

supervisory role is an advantage. A clean class 4 drivers’ licence.