At PPS Healthcare Administrators, I audit hospital and professional claims against clinical records, scheme rules and funding policies. I review high-cost cases for billing anomalies, coding accuracy and financial risk, and prepare audit reports with findings and follow-up actions.
Previously, as a Specialised Case Manager at Life Peglerae Hospital, I documented clinical information to support funder decisions on length of stay and level of care. I also coordinated procedure authorisations and prosthesis quotations with clinicians and funders.
My earlier nursing experience includes Neuro-Surgical ICU Nurse at Chris Hani Baragwanath Academic Hospital and Professional Nurse roles at Netcare Milpark Hospital and Medicross Princess Crossing. I bring that clinical background to claims auditing, healthcare authorisations and provider query resolution.
