Medical Aid Claims Administrator [FH] [South Africa]


 

Our client, an IT software provider in the healthcare industry, is in search of a Medical Aid Claims Administrator to join their dynamic and fast-paced Admin department.
Duties & Responsibilities:

  • Manage the Doctor’s account remotely.
  • Reconcile remittances.
  • Query outstanding claims.
  • Resubmit outstanding claims.
  • Maintain a low age analysis.
  • Follow up on short payments.
  • Flag claims regularly with updates.
  • Clear Ontime rejections.
  • Submit query reports to clients.
  • Selecting correct scheme agreements.
  • Maintain the ERA database.
  • Identify tariff issues
  • Constant liaison with client and logging of communication.
  • General filing and admin.

Requirements:

  • 3 years experience as a medical aid claims administrator.
  • Deadline driven (Client turnaround time: 48 hours)
  • Independent thinker; problem solver.

Qualifications:

  • Matric certificate.

CTC includes Medical Aid and Provident Fund contribution.

Job Type: Full-time

Salary: R7,000.00 - R9,500.00 per month

Application Question(s):

  • What is the difference between a tariff and an ICD-10 code?
  • What makes a claim patient liable?

Education:

  • High School (matric) (Required)

Experience:

  • Medical Aid Claims: 3 years (Required)


 

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