Officer: Bill Review - 12 Month Fixed Term Contract at Six Senses

Role summary

• A well-established financial services business is seeking to appoint an Officer: Bill Review for a 12 Month Fixed Term Contract
• Audit & review medical bills
• Analysis of claimed items/services in correlation with available tariff structures and ICD 10 /CPT 4 codes.
• Requesting motivation for unreasonable accounts
• Line by line analysis of claim items/service. Matching those appropriate tariffs/ ICD/CPT codes.
• Flagging rejected items/services.
• Recommendations to the department responsible for processing payments
• Auditing medical claims and assisting in technical aspects of bill review

Qualification and Experience:

• Bachelor’s Degree or Advanced Diploma in nursing/ Allied Health Professions or related qualification
• Relevant 3 years’ experience in a medical field.
• Registration with the relevant Health Professional Council
• Technical and behavioral competencies required.
• Computer literacy
• Ability to interpret the rules of the UPFS tariffs.
• Analytical skills
• Organizational & administrative skills
• Planning and Organizing
• Decision making
• Negotiation skills
• Personal mastery
• Emotional wisdom
• Ethics and governance
• Customer orientation and customer focus

Closing date:  2025-07-21