B Tech Degree OR CCA Qualification
Valid Registration with the HPCSA as an Advanced
Life Support (Paramedic)
Minimum 5 Years Emergency Medical Services
Experience, with atleast 1 Year at a supervisory
level
Knowledge of Microsoft Office, Qlickview
Key Outputs:
Manage, train, recruit and develop staff of the
claims department
Verify that targets are benchmarked, set, agreed
with staff members in conjunction with the
department objective
Monitor staff performance against targets and
address poor performance
Coach staff on their areas of development
Manage any human resource relations activities
and issues that need to be dealt with, either in
person or via escalation to the relevant people
Following set out guidelines on assessing case
sheets
Assess case sheets according to HPCSA protocols
and employer policies
Maintain channels of communication with the
clinical team and employer operational staff
Liaise with the branch managers, regional
managers and support staff to ensure that
information can be shared about clinical issues
Attend branch meetings, regional meetings and
flight meetings to review cases and discuss
clinical issues
Ensure that the clinical team and employer
operational staff has good communication
channels
Preparation of reports to funds and schemes
Generate reports regarding turnarounds, volumes
of claims, settlement amounts and pending
claims for funds and schemes, as well as for
internal review purposes, these are prepared
monthly and made available on Qlikview, with a
physical report prepared for Manco
Generating of additional reports on an ad hoc
basis for Regional Management in terms of service
provider utilisation and activities
Ensure that any irregular activities by service
providers are highlighted and advised to Fund
Managers and Chief Operating Officer
Engage in information sharing and relationship
building with the branches
Operational front line work
Support the claims assessors with case reviews
Reviewing cases with the clinical assessment
team
Provide clinical support and direction on cases to
assessors
Continuous optimisation of processes in place to
minimise risks and enhance service levels to
service providers and clients of employer
Constant awareness of issues, bottlenecks in the
process and regularly arising problems as well as
possible solutions or alternatives considered,
tested, submitted for approval and implemented
to ensure that service rendered is of international
standards
Internal communication of any changes to the
processes or requirements from schemes to
ensure optimisation and avoidance of
unnecessary problems and delays
City/Town: Paulshof
Location: Gauteng
How to apply: Email, Fax
Company: Medical Human Resources
Contact: Lindie Greeff
Fax: 0866827104
Email: lindie.greeff@mhr.co.za
