8 Medical Staff jobs in Eastern Cape

Our client operating in the medical insurance space is seeking a Medical Claims Clinical Auditor to join their team based in Port Elizabeth - on a 6 month fixed term contract.
Nursing Diploma or Degree essential!
EE candidate preference.
An awesome career opportunity awaits!

Role Purpose
The purpose of this temporary role is to ensure hospital claims are audited timeously and accurately with the focus on reducing wastage and abuse, as well as to ensure that claims are processed according to authorizations for a period of 6 months only.

Requirements

• A National Senior Certificate is essential.
• It is essential to have a Nursing Diploma or Degree.
• The incumbent must be registered with the South African Nursing Council (SANC) as a Registered Nurse.
• MS Office / Office 365 proficiency.
• Minimum of 2 years’ private hospital nursing experience.
• Previous exposure to clinical auditing is highly advantageous.
• Be available to work at one of our offices based in Richmond Hill (Gqeberha), Cornubia (Durban), Bellville (Cape Town) or Centurion.

Responsibilities

INTERNAL PROCESS

• Apply scheme rules, clinical policies and protocols to funding.
• Action allocated hospital claims for audit within department KPIs and CMS requirements for claims payment.
• Ensure accurate notes are made for all journals actioned on claims audited.
• Assess prosthesis for PMB funding when benefits are exceeded or if there is no benefit.
• Ensure accurate completion of authorizations on claim finalization.
• Refer LOC/ LOS / item or drug approval queries to case managers for resolution.
• Act as clinical support to non-clinical hospital claim auditors in terms of hospital tariff applications and clinical guidance (e.g. procedures, devices and drug utilization).
• Survey claims for correct application of tariff and refer discrepancies to the relevant team.
• Review retrospective claim approvals and send journal instructions for additional payments to the relevant team.
• Review hospital claims for clinical appropriateness, treatment authorized, over-usage of equipment/materials, application of billing rules and high-cost medication appropriateness.

CUSTOMER SERVICE

• Investigate hospital claim queries within the agreed service level and ensure that the relevant stakeholder receives timeous feedback.
• Escalate queries to the relevant team or stakeholder.
• Provide accurate information and advice to stakeholders to ensure that they receive the appropriate service.
• Resolve claim queries accurately and timeously.
• Build and maintain relationships with internal and external stakeholders.
• Reduce claim rejections to ensure members are not held liable for unnecessary costs.

PEOPLE

• Build strong relationships through expressing positive expectations.
• Continuously develop own expertise in terms of industry and subject matter development and application thereof in an area of specialization.
• Contribute to continuous innovation through the development, sharing and implementation of new ideas and involvement of colleagues and staff.
• Participate and contribute to a culture of work centric thinking, productivity, service delivery and quality management.

FINANCE

• Identify opportunities to enhance cost effectiveness and increase operational efficiency.
• Manage financial and other company resources under your control with due respect.
• Provide input into the risk identification processes and communicate recommendations in the appropriate forum.

Competencies

• Teamwork
• Examining information (interrogate claims data)
• Articulating information
• Upholding standards
• Accountability
• Attention to detail
• Time management

Please consider your application unsuccessful if you are not contacted within two weeks of applying.

Monthly

Our client operating in the medical insurance space is seeking a Medical Claims Clinical Auditor to join their team based in Port Elizabeth - on a 6 month fixed term contract.
Nursing Diploma or Degree essential!
EE candidate preference.
An awesome career opportunity awaits!

Role Purpose
The purpose of this temporary role is to ensure hospital claims are audited timeously and accurately with the focus on reducing wastage and abuse, as well as to ensure that claims are processed according to authorizations for a period of 6 months only.

• A National Senior Certificate is essential.
• It is essential to have a Nursing Diploma or Degree.
• The incumbent must be registered with the South African Nursing Council (SANC) as a Registered Nurse.
• MS Office / Office 365 proficiency.
• Minimum of 2 years’ private hospital nursing experience.
• Previous exposure to clinical auditing is highly advantageous.
• Be available to work at one of our offices based in Richmond Hill (Gqeberha), Cornubia (Durban), Bellville (Cape Town) or Centurion.

• Apply scheme rules, clinical policies and protocols to funding.
• Action allocated hospital claims for audit within department KPIs and CMS requirements for claims payment.
• Ensure accurate notes are made for all journals actioned on claims audited.
• Assess prosthesis for PMB funding when benefits are exceeded or if there is no benefit.
• Ensure accurate completion of authorizations on claim finalization.
• Refer LOC/ LOS / item or drug approval queries to case managers for resolution.
• Act as clinical support to non-clinical hospital claim auditors in terms of hospital tariff applications and clinical guidance (e.g. procedures, devices and drug utilization).
• Survey claims for correct application of tariff and refer discrepancies to the relevant team.
• Review retrospective claim approvals and send journal instructions for additional payments to the relevant team.
• Review hospital claims for clinical appropriateness, treatment authorized, over-usage of equipment/materials, application of billing rules and high-cost medication appropriateness.

• Investigate hospital claim queries within the agreed service level and ensure that the relevant stakeholder receives timeous feedback.
• Escalate queries to the relevant team or stakeholder.
• Provide accurate information and advice to stakeholders to ensure that they receive the appropriate service.
• Resolve claim queries accurately and timeously.
• Build and maintain relationships with internal and external stakeholders.
• Reduce claim rejections to ensure members are not held liable for unnecessary costs.

• Build strong relationships through expressing positive expectations.
• Continuously develop own expertise in terms of industry and subject matter development and application thereof in an area of specialization.
• Contribute to continuous innovation through the development, sharing and implementation of new ideas and involvement of colleagues and staff.
• Participate and contribute to a culture of work centric thinking, productivity, service delivery and quality management.

• Identify opportunities to enhance cost effectiveness and increase operational efficiency.
• Manage financial and other company resources under your control with due respect.
• Provide input into the risk identification processes and communicate recommendations in the appropriate forum.

• Teamwork
• Examining information (interrogate claims data)
• Articulating information
• Upholding standards
• Accountability
• Attention to detail
• Time management

Please consider your application unsuccessful if you are not contacted within two weeks of applying.

Monthly

Medical Resources Group , a trusted healthcare recruitment partner, is assisting a leading and expanding medical practice in Selborne, East London with the recruitment of an experienced Medical Practice Manager .

This exciting role will suit a confident, ambitious professional with proven experience in medical practice management and the ability to lead a dynamic team.

Position: Medical Practice Manager

Location: Selborne, East London
Start Date: 1 November 2025
Working Hours:

• Monday to Friday: 08h00 – 17h00
• Alternate Saturdays: 09h00 – 13h00

Key Responsibilities

• Lead, train, and manage medical and administrative staff.
• Oversee financial administration, billing, and reporting.
• Manage patient scheduling and ensure excellent patient flow.
• Ensure compliance with medical regulations and best practices.
• Manage suppliers and oversee procurement.
• Remotely support medical staff in other branches and assist with expansion projects.

Requirements

• Minimum 3 years’ experience as a Medical Practice Manager (multi-practitioner management advantageous).
• Proven experience in the medical industry (mandatory).
• Strong knowledge of billing software (Medis or similar).
• Qualification in business management, healthcare management, or logistics (advantageous).
• Assertive, confident leader with excellent communication and organisational skills.
• Professional, punctual, and able to motivate a young, ambitious team.

What’s on Offer

• Competitive market-related salary (aligned with candidate experience and expectations).
• An opportunity to be part of a growing, ambitious practice expanding beyond dentistry.
• A leadership role with real impact and growth opportunities.

How to Apply:
If you meet the above requirements and are ready to take on this exciting challenge, please send your CV and supporting documents to Medical Resources Group

Business Unit: Royal Buffalo Specialist Hospital

Posted: , Closing:

Location: Eastern Cape, East London

An opportunity is available for 2x Registered Nurses (Medical) reporting to the Unit Manager. The successful candidates will form part of the multidisciplinary team ensuring that all our patients receive comprehensive quality nursing care.

Effective cost management for staff and stock by:

• Minimising unnecessary stock wastage and facilitating maintenance of equipment.

• Providing quality patient care.

• Assist in identifying and ensuring staff undergo department specific micro-orientation.

• Ensuring daily care rounds are conducted and investigating complaints.

• Providing accurate, appropriate and adequate information to patients and family members during hospitalization.

• Monitoring and implementing preventative measures to minimize risk.

• Comply with all requirements in order to facilitate infection control.

• Conducting effective relationships with internal and external stakeholders.

• Identifying doctor’s preferences and stakeholders needs and implement in the working environment.

• Registered with the South African Nursing Council as a Registered Nurse.

• Two years’ experience working as a Registered Nurse in a Medical ward in private healthcare.

• Collaboration/ Relationship Building
• Resilience
• Verbal & written communication and presentation skills
• Negotiation
• Ethical behaviour
• Decision making

• Nursing

• To recruit, screen and provide clinical management to participants in clinical trials according to study protocols

• Clinical HIV Research Unit, Sizwe Tropical Disease Hospital, Sandringham, Johannesburg

• Clinical assessment, treatment and/ or referral of participants who participate in the study
• Participate in routine assessment of participants in accordance with the protocols, including relatedness assessment of AEs
• Initiate, maintain and strengthen referral systems via direct interaction and assist in the establishment of Memorandums of understanding (MOUs) as required by the study protocol/s
• Conduct regular liaison with the laboratory regarding the interpretation of diagnostic test It is the responsibility of the clinician to ensure that an appropriate management plan is followed as a result of receiving diagnostic test results
• Quality control of case report forms with respect to clinical activities
• Screen and enrol eligible patients in accordance with study protocol and ethical guidelines
• Review patient vital statistics and other study-related results
• Treat opportunistic infections, STIs, comorbidities, etc as diagnosed
• Prescribe the appropriate treatment and management plan
• Report any adverse events and follow-up on patients, including timeous electronic reporting of adverse events/ SAEs as required
• Follow-up on patients who have been admitted to hospital, including other provincial hospitals
• Data collection and storage of data according to GCP and study SOPs
• Development, updating and refining of source documents as required
• Recruitment and retention according to set accrual targets as required by the sponsors
• Set up and maintenance of trial documentation required by regulatory authorities (Wits HREC)
• Development and ongoing revision of standard operating procedures compliant with sponsor and unit guidelines
• Ensure the maintenance of the study essential documents as per the CHRU / study SOP
• Provide regular clinical support to the clinic staff to ensure that clinical management of participants is of a high quality and complies with HPCSA
• Identify research questions in specialist area
• Write grant proposals, protocols and ethics applications in order to fund and perform research studies
• Implement research studies in conjunction with the research teams
• Attend, present and participate in organisational research and academic meetings
• Ad hoc duties to ensure accurate, safe and timeous protocol implementation
• Produce monthly progress reports which document recruitment and retention activities including study outcomes
• Proactively resolve protocol queries and missing data with the Research Team
• Complete source notes and patient logs
• Capture patient data on the Case Report Forms
• Attend meetings (in person and virtual) as required
• Engage and meet with Sponsors and Monitors as required
• Attend to all staffing requirements and administration
• Conduct ad hoc training on clinical topics as required
• Supervise and manage the duties of subordinates to ensure optimal staff utilisation and maintenance of sound labour relations
• Perform and facilitate performance development and assessments
• Identify substandard performance by team members and take necessary corrective action
• Coach and train subordinates and team members to ensure the acquisition of knowledge and skills required by the organisation
• Promote harmony, teamwork and sharing of information
• Take ownership and accountability for tasks and demonstrate effective self management
• Follow through to ensure that quality and productivity standards of own work are consistently and accurately maintained
• Maintain a positive attitude and respond openly to feedback
• Take ownership for driving own career development by participating in ongoing training and development activities such as workshops, forums, conferences etc.
• Participate and give input in ad hoc projects and initiatives

• MBBCh Degree
• HPCSA registration in good standing with independent practice

• GCP qualification advantageous
• Working knowledge of DR-TB, Paediatric experience, and Spirometry training advantageous

• Permanent Part-time role as Medical Doctor in Clinical Research in Paediatrics, Pregnancy and adults with DR-TB

• Only if you meet the minimum job requirements and experience as mentioned above, you may submit a detailed updated CV.
• Please Apply Online and complete your registration via our website to enable and protect you as a candidate, and to accept the new POPIA terms and conditions.
• This will then create your permanent profile with which you can apply for all jobs as advertised by AJ PERSONNEL.
• However, you may remove your profile from AJ PERSONNEL when you are no longer in the job market.
• Please take note that the applicants who do not adhere to the above criteria will not be considered for the respective position.
• Wits Health Consortium will only respond to shortlisted candidates.
• Candidates who have not been contacted within two weeks of the closing date can consider their applications to be unsuccessful.
• Closing date: 5 September 2025
• Note: No CV will be accepted after the closing date

• WHC, in accordance with its Employment Equity goals and plan, will give preference to suitable applicants from designated groups as defined in the Employment Equity Act 55 of 1998 and subsequent amendments thereto.
• AJ Personnel is only responsible for advertising and the response handling on behalf of their client Wits Health Consortium.
• AJ Personnel does not have any salary or other information regarding the position