Pensions Medical Case Assessor 4 Months Contract - Parktown, South Africa - Rand Mutual Assurance

Rand Mutual Assurance

Verified Company

Parktown, South Africa

1 week ago

Posted by:

Thabo Mthembu

beBee Recruiter

Description

THE JOB AT A GLANCE

As the Pensions Medical Case Assessor (PMCA), you will be responsible for effectively and efficiently rendering medical support to internal and external stakeholders.

WHAT WILL YOU DO?

Monitoring of Hospital Admissions weekly and liaison with Case Managers.
Give feedback to Case Managers and other Colleagues of Pensioners admitted in Hospitals and include for hospital utilisation management.
Authorization of Pensioners Hospital admissions, Chronic Medications and Sundries, prosthetic repairs and replacement
Adjudicate requests for subsequent care and refer to RMA doctor as necessary.
Assess and adjudicate medical service provider reports and advise on invoices submitted and captured when requested.
Visit medical service providers and hospitals to address Pensioners related issues
Organize and attend scheduled clinics.
Organize transport for SCI acute admissions, uro reviews and taxi fares for prosthetic pensioners.
Visit existing high risk/cost and new DRG 1 pensioners as per PMP schedule.
Organizing uro reviews and capture the uro report.
Organize prosthetic review clinic and load report on CC
Assist to obtain death certificate and Notification of Death (if available) for deceased pensioners and autopsy reports if available.
Assist with medical walkin office clients.
Capture Medical Reports via scanning in respect of pensioners, chronic medication, and subsequent care and specific medical reports requested.
Assist with education of pensioners on entitlements.
Updating DOCR with hospital pensioner admissions and discharges for DRG 1 to
Weekly/Monthly report of Pensioner URO reviews, home visits and prosthetic reviews and other interventions.
Manage visa and passport expiry documents of SCI pensioners in Hospital.
Managing and control of medical expenses as per yearly plan
Follow up, from RMA system generated reports, high cost claims based on type of injury and estimated costs.

WHAT YOU'LL BRING TO THE TABLE?

Nursing diploma /degree
3 years nursing experience as professional nurse
Valid Driver's License
Registration with Nursing Council or relevant Health Professional Council
Building Customer Loyalty
Contributing to Team Success
Managing Work (includes Time Management)
Stress Tolerance
Decision Making
Confidentiality
Credibility
Friendly
Initiative
Integrity

WHAT WILL YOU GET IN RETURN?

This is an exciting opportunity within the Rand Mutual Assurance team, offering exposure to an interesting combination of technical and business issues.

This is a great time to join RMA as we look to grow the Life business and develop our actuarial team.

We offer great opportunities for personal and professional development in a stable company that's 128 years strong. The role comes with a competitive salary package and various benefits. Flexible work arrangements (combination of remote and in the office). Furthermore, you will be a part of a dedicated group of colleagues who value teamwork and collaboration.

Turnaround time

Closing date:

Our Commitment to transformation: