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Vacancy Details

		A job opportunity

A job opportunity exists for the right candidate in Western Cape

The Department of Health and Wellness is guided by the principles of Employment Equity. Candidates with disabilities are encouraged to apply and an indication in the regard will be appreciated. Note: No payment of any kind is required when applying for any of the positions advertised by the Western Cape Government.

Experience:
Senior State Accountant: Finance (Medical Aids/Schemes)
Employment Type: Permanent
Reference No: HO62/2018
Head Office, Cape Town

Appropriate public and private sector experience regarding the management of medical scheme claims. Appropriate experience and knowledge of scheme rules, legislation and claims management in the Medical Scheme industry. Appropriate working experience with medical scheme claims at a medical scheme or administrator.

Competencies (knowledge/skills):
Computer literacy in Microsoft Office applications (Word, and Excel). Effectively interpret medical scheme data from the Department’s billing systems and/or from the respective schemes. Knowledge of medical scheme governing bodies, e.g. BHF and CMS. Knowledge of public and/or private sector tarrif structures. Knowledge of the Hospital Fees policies and procedures. Knowledge of legislative governance relating to medical schemes. Knowledge of operational and management aspects pertaining to the processing of claims within the medical scheme industry.

Enquiries:
Ms L Ismail, tel. no. (021) 940-4553

Duties (key result areas/outputs):
Oversee submission of medical scheme claims, including interaction with the Department’s EDI service provider. Extensive liaison with the various medical schemes re the follow-up of unpaid medical scheme claims. Provide support and or liaise with the Department’s facilities regarding the management of claims, legislative requirements and industry changes pertaining to medical schemes. Compile departmental policy directives regarding medical scheme claims. Obtain and analyse data in respect of the Department’s Accounts Receivable systems and third party systems. Identify underlying reasons for short or non payment of claims and resolve with medical schemes. Perform ongoing validation of medical schemes registered in the Department’s Accounts Receivable systems. Validation of Practice numbers (PCNS) with the Board of Healthcare Funders. Represent the Department in engagements with internal and external clients.

Requirement
Senior Certificate (or equivalent) with Mathematics and/or Accountancy as passed subject and/or Senior Certificate with appropriate experience/competencies that focuses on the Key Performance Areas (KPA's) of the post.

Inherent requirements of the job:
Valid (Code B/EB) driver’s licence. Willingness to travel on a regular basis away from work place to visit the Department’s facilities.




Remuneration:
R 299 709 - R353 043 Annual salary plus service benefits (13th cheque, employer's contribution to the pension fund, housing and medical aid allowance).

Starting Date:
9/21/2018 12:00:00 AM

NOTICE TO ALL
Candidates may be subjected to a competency test. No payment of any kind is required when applying for this post. As directed by the Department of Public Service and Administration, applicants must note that further checks will be conducted once they are shortlisted and that their appointment is subject to positive outcomes on these checks, which include security clearance, qualification verification, criminal records and previous employment. It will be expected of shortlisted candidates to be: available at the venue on the time and date as determined by the Department and bring along recently (not older than 6 months) certified copies of your Identity Document (ID), driver’s license (if applicable for the post), qualification and/or proof of registration at relevant statutory body. Failure to adhere to the aforementioned may lead to his/her application being disqualified and not further considered.
Closing date: 10/12/2018 12:00:00 AM

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