Established company is looking for experienced medical Claims Assessors. The candidate will ensure that all claims are assessed using the appropriate company rules and is paid correctly in line with the company benefit and tariff structures.

Responsibilities:

· Assess validity of claims using the relevant Scheme rules, NHRPL, Industry rules etc

· Ensure that claims are paid correctly within agreed timeframes and according to the

Scheme Rules

· Resolve member and provider queries

. Complete production forms on a daily basis and report required statistics

Minimum Requirements: (These requirements ARE NOT NEGOTIABLE)

Grade 12

Claims Assessing Certificate

Expert claims knowledge

ICD10 and coding knowledge and experience

Microsoft Word

Bilingual - Afrikaans and English

Salary:

R 190k - R 210k ctc per annum includes benefits