Temporary Consultant vacancies at Road Accident Fund
Deadline: 25 October 2024
Location: Johannesburg, South Africa
Temporary Consultant vacancies at Road Accident Fund
Road Accident Fund is recruiting and accepting applications for Temporary Consultant vacancies.
Purpose: The Consultant: Medical Management is responsible to implement the medical management activities, medical exception handling and providing administration support in claims processing.
NB: This is a 12-Month Fixed-Term Contract position.
Key Performance Areas
Medical Management.
- Conduct medical assessment and compile injury assessment reports.
- Conduct assessments and bill reviews on submitted claims, focusing on the appropriate level of care, the length of stay, and quality of care.
- Incorporate tariffs, cost savings initiative recording, and treatment protocol to ensure that all service providers adhere to the rules, and the tariff as guided by the RAF and / or any that is considered reasonable.
- Pre authorise submitted claims aligned to RAF clinical guidelines including the RAF formularory, treatment protocols and related tarrifs.
- Escalation of complex cases for multi disciplinary review and adjudication.
- Participate in the consultations process on the implementation of medical claims processes.
Exception Handling.
- Ensure the implementation and maintenance of a formal exception handling process within the medical management.
- Maintain the documentation and regular updating of the exception handling process.
- Maintain the implementation an unusual occurrence procedures.
Reporting.
- Track and report against set objectives and targets.
- Report on emerging risks.
- Provide ad hoc reports on process improvement initiatives.
- Produce documents, briefing papers, reports and presentations.
MORE OPPORTUNITIES:
- Receptionist vacancy at Intercare Group
- Wellness Assistant vacancies at Clicks Group
- Mechanical Fitter Apprenticeship at AECI
Stakeholder Management
- Deal with/and respond to correspondence.
- Maintain healthy relationships with all stakeholders.
- Follow up and resolve all queries, following up and making recommendations on which corrective actions are appropriate.
- Follow up and feedback to all stakeholders to keep them updated on the status of a query.
- Respond to queries within the predefined turnaround times.
Qualifications
- Bachelor’s Degree/Advanced Diploma in Health Sciences /Medical related qualification.
- Registration with HPCSA/SANCA.
Experience
- Relevant 3 years’ experience in a Medical related environment.
Technical and behavioral competencies required
- Claims management process/ processes and systems.
- Medical product management
- Medical bill reviewing
- Medical case management
- Complex problem identification, solving and decision making
- Customer value proposition
- Strong clinical analytical capabilities
- Knowledge of motor vehicle accident legislation
- Planning, Organising and Coordinating
- Personal Mastery
- Judgement and Decision Making
- Ethics and Values
- Client Service Orientation
Application
To apply, visit Road Accident Fund careers portal.
Applicants who have not received any correspondence from us within six weeks from the closing date can consider themselves unsuccessful.
Careers Office is on Social media platforms for more updates, follow our WhatsApp channel.