Genesis Medical Scheme is seeking a Non-Disclosure Investigator that would be responsible for identifying and investigating suspected cases of member non-disclosure, misrepresentation, or omission of material medical information during the application process for medical scheme membership.
The role is responsible for assessing whether medical conditions, symptoms, treatments, or consultations existed prior to scheme application and whether these were appropriately disclosed during underwriting.
Experience:
Experience (3-5 years) in Hospital authorisations, Claims Investigations, non-disclosure investigations, with demonstrated expertise in gathering evidence, analysing clinical information and identifying risk is essential.

Knowledge & Technical Skills:
Medical scheme operations
Underwriting and waiting periods
Understanding Anatomy
Clinical coding (ICD-10, tariff codes)
Strong report-writing and investigative skills.
Advanced analytical and problem-solving ability.

Competencies:
Investigative mindset
Attention to detail
Excellent written and verbal communication
Review membership application forms, underwriting declarations, and supporting documents.
Assess whether pre-existing conditions, symptoms, consultations, investigations, or treatments existed prior to membership inception.
Establish clinical and treatment timelines in relation to application and joining dates.

Please forward your CV to vacancies@genesismedical.co.za before 16 September 2026.