A managed care company based in Century City (Cape Town) is looking for a professional, motivated and well-spoken individual to fulfil this vacancy.
This role will incur travel nationally, inclusive of day trips and/or overnight stays.
To review and assess clinical cases, in line with business protocols to maintain service levels.
To manage the risk on behalf of the client, thereby managing the scheme’s risks.
Attend Wellness days to carry out oral screenings and provide oral hygiene instruction.
Job specification; duties include, but are not limited to:
1. Clinical Assessing
a. Clinically assess and review cases and treatment plans:
i. Crown & Bridge
iv. Medically compromised
v. Maxillo Facial
viii. Irregular Claiming patterns
x. Retrospective claim review
xi. Tooth Charts
2. Operations Management
a. Monitoring and querying irregularities with regards to pre-authorisation applications
b. Ensure incorrect information provided by consultants is escalated to Team leaders
c. Provide support to Operations team
d. Review, analyse, monitor and report variances
e. Monitoring and research of trends in the dental industry
3. Wellness Programme
a. Attend Wellness events (National)
b. Perform oral screenings and provide oral hygiene instruction to member
c. Provide Benefit advice to members
d. Manage and monitor promotional stock
e. Scheme liaison regarding arrangements of Wellness events
- Analysis and problem assessment
- Teamwork / Collaboration
- Excellent communication skills and client services oriented
- Ownership of tasks and functions
- Planning and organising initiative
- Quality orientation and attention to detail
- Information monitoring
- Bachelor Degree or Diploma of Oral Hygiene
Knowledge / Skill requirements, Experience, Licences / Registrations
- 3 – 5 Years clinical practice experience
- Any Specialist practice experience beneficial
- Ability to read and assess X-rays essential
- Previous exposure to the medical aid industry beneficial
- Valid Driver’s License with no endorsements
- Computer literate in Microsoft Word, Excel and Outlook packages
- Registered with HPCSA
- Credit and criminal clearance is a requirement for consideration.
- Own or reliable transport necessary.
- A competency-based recruitment and selection method may be used as part of the interview process and candidates should therefore demonstrate the appropriate technical and behavioural competencies, business understanding and interpersonal skills.
Type of business: Dental benefits management for various medical aids based in Century City.
Salary range: Market Related
Hours: Shift rotation basis (standard 8-hour day)
Monday to Friday: 07h00 to 18H00
Saturday: 08H00 – 12H00
(The work week remains a 40-hour week)
Number of vacancies: 2
Due date: Applications close [Wednesday, 8 May 2019]
Apply to: email@example.com
Dental Information Systems (Pty) Ltd
T +27 21 528 5300 l F +27 86 6770336
Block D, The Forum, North Bank Lane, Century City 7441 l P O Box X1, Century City, 7446
Reg. No. 1996/000371/07
Directors: Z Mayet, PAP Leroy, DC Carolus, HL Nhlapo