Job Opportunities at Discovery Limited

Key Outputs

• Responsible for tasks related to the HealthyFood Studio, products and projects need to align with and meet the objectives of Discovery Vitality Wellness / Partner Operations.
• Establishing, leveraging and maintaining all administrative tasks, but not limited to.
• Ensure, Plan, organise and manage all daily tasks. 
• Maintain files and records so they remain updated and easily accessible.
• Take minutes of meetings and dictations, assist in office management and organization procedures
• Document and report on tasks and manage all invoicing in accordance with finance needs.
• Prepare for monthly meetings, take minutes and assist with stats for Dashboard (masterlist)
• Manage online bookings internal and external bookings and enquiries.
• Arrange the relevant documentation needed for public to ensure easy journey experienced when booking or enquiring about the Studio.
• Perform ad hoc Vitality Wellness / Partner Operations tasks as required e.g., draft and respond to member and partner queries
• Assist with tracking and schedule meetings with all partners, weekly catch-up sessions and relationship building

Daily operations:

• General – emails, calls, communication, capturing data and client relations
• Booking system – bookings, moved, refund, cancelled, reporting, finance invoices, manual, update daily calendar and load new courses
• Document and report all the administrative processes (master list, invoice log, campaign sheet, promotion codes)
• Send weekly updates of bookings and current stats
• Events and catering requests (Assistance required)
• Assist with the development of effective project plans to manage courses and events
• Oversee all orders and requirements for catering and events
• Attend to basic bookings for team builds and courses
• Special events, arrange all needs, staffing, hiring in goods, management on the day, marketing, PR etc
• Master classes – Manage chef booking, legal, finance, marketing, PR and event set up and logistics
• Plan and manage budgets - oversee finance and reconciliation of events/ bookings

Key skills and attributes

• Vitality product knowledge
• Internal operations, processes, procedures
• Verbal / written communication
• Time Management
• Relationship Management and People Skills
• Problem Solving Skills
• Teamwork Computer literacy (MS Word, Excel, PowerPoint, Outlook)
• Effective communication at all levels within and outside of the organisation
• Excellent administrative skills

Work experience and qualifications

• 1-2 years’ experience – Corporate, Hospitality, industry, PR and Events 
• 1 - 2 years’ with internal operations, processes and procedures experience

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Key purpose

• This position falls within the hospital risk unit and the successful candidate will be required to conduct clinical audits on hospital claims and events data, identify potential risk from inappropriate billing against industry rules and contractual agreements. Develop strategies to mitigate risks identified, apply control measures to manage hospital costs and ensure appropriate reporting to all stakeholders.

Key Outputs

The successful candidate will be responsible for but not limited to:

• Identifying potential risk areas in terms of hospital and pathology billing trends.
• Proactively engage with analysts in understanding risks to the scheme, log data requests and propose corrective measures
• Auditing of coding quality initiatives already identified within the operational areas (pre-auth and case management)
• Identify additional coding quality concerns not already addressed and come up with suggestions for further auditing and improvement initiatives

Auditing of a wide range of data:

• Hospital claims data
• Case management data
• Hospital contracts clinical data
• Reverse and record recoveries.
• Develop strategies to address inappropriate billing and propose control measures.
• Regular engagement with hospital groups and other stakeholders on inappropriate billing trends.
• Daily support to the hospital team and operations to ensure hospital related  initiatives are delivered on time.
• Influence the maintenance of benefits, input on escalated cases and review of bene-fits\protocols. 
• Providing prompt and accurate feedback to all stakeholders
• Internal presentations  as a subject matter expect at various forums when necessary.
• Building good relationship with internal and external stakeholders.

Competencies

The successful incumbent must be able to demonstrate the following competencies:

• Must be detail oriented
• Ability to self-manage and work within a team simultaneously
• Stakeholder interaction on a professional level with internal and external clients for whom we conduct audits
• Ability to express opinions, information and key points of an argument clearly
• Monitors performance against deadlines and milestones
• Sets high standards for quality and quantity
• Makes rational judgements from the available information and analysis
• Takes initiative and works under own direction
• Focuses on customer needs and satisfaction
• Upholds ethics and values; demonstrates integrity
• Flexible in handling multiple projects simultaneously

Qualifications & Work Experience

• Matric/ Matric equivalent 

Clinical Qualification

• Working knowledge of Outlook, Excel, Word and Power point computer packages are essential 
• Must have completed coding training at least to an intermediate level, with a view towards undertaking an advanced local accreditation course (thus must be willing to study further)
• Previous auditing experience 
• ICD-10, (CCSA.) coding and other coding schemas experience
• Case management experience
• A good understanding of industry coding processes and industry forums in which Discovery and the Coding Unit participate
• Discovery claims and product experience
• Bill audit review experience