Bestmed Medical Scheme is looking for a Clinical Hospital Auditor to work in their Hospital Benefit Management team. This role is based in Pretoria, Gauteng, and is a permanent position. Bestmed is a well-known medical scheme in South Africa that has been helping people access healthcare for over 60 years.

As a Clinical Hospital Auditor, you will check hospital claims and related medical information to ensure they follow the rules of the scheme and the contracts with healthcare providers. You will review diagnoses, treatments, and outcomes for proper recording, identify overcharging, and ensure correct reimbursement. You will collaborate with team members to resolve issues, improve care quality, and enforce scheme rules for services like prosthetics.

Requirements: Grade 12 completion, Bachelor of Curative degree or Nursing diploma, SANC registration, and at least 5 years of nursing experience (2+ years in medical funding). Strong attention to detail and teamwork are essential.

Benefits include 23 days annual leave, 8-hour workday with 30-minute lunch break, corporate umbrella fund (life insurance, disability, funeral, pension), medical aid, training, free Wi-Fi, on-site gym, and wellness program. Bestmed promotes professional growth and a respectful workplace.