Clinical Audit Specialist - Oncology


Clinical Audit Specialist – Oncology Claims

Location: Observatory, Cape Town
Salary: R420k – R540k per annum negotiable depending on experience

About the Role:
Opportunity available for a Clinical Audit Specialist within the Clinical Division of a leading private medical scheme in South Africa. The position offered will suit a self-motivated and driven person who will be assisting in the auditing of oncology claims, in and out of hospital.

Nursing Qualification (RN)
Experience in Medical, Surgical and Oncology field
5 years with tariff schedules and Hospital/Doctor billing guidelines
Good knowledge of the SAMA Billing Guide
Knowledge of ICD10 and CPT4 coding
Basic knowledge of Medical Terminology
ICU and Theatre experience
Attention to detail with an investigative mind
Confident with a good team player attitude
Strong administrative skills
Strong verbal and written communication
Strong organizational skills with the ability to multi-task

Auditing of accounts, applying industry rules and guidelines as set out in the relevant Tariff and Billing Rules, with outstanding administration skills.
Assisting in the auditing of oncology claims, in and out of hospital.