Medical Aid Claims Administrator – R13 to R15 000.00 – Bryanston

We have a new opportunity for an experienced Medical Aid Claims Administrator for our client a forward thinking and progressive medical aid organisation based in Bryanston
The successful candidate needs to meet the following criteria:
• A minimum of at least 4 to 5 years’ experience in a similar role as a medical aid claims administrator
• Sound understanding of the South African Medical aid or Health insurance benefits and options
• Computer literate - MS Office suite, i.e. Word, Excel
• Knowledge of ICD codes and medical procedures
• RPL tariff knowledge
• Matric
• Ability to liaise with external and internal parties
• Ability to work within an established team
• Excellent oral and written communication skills
• Customer centric attitude
• Pays attention to detail
• A good understanding of claims risk profiling
• A good understating of creating standard operating procedures
• Experience in working on the MIP Administration System is advantageous
• Willing to go the extra mile
• Knowledge and understanding of how claim modifiers work.
• Knowledge and understanding of how service provider claims are assessed, i.e. paper and electronic claims
• Good understanding of electronic claim submissions via switching houses and bureaus