Medical Aid Claims Administrator - Bedfordview Verfied

Salary Negotiable Bedfordview, Gauteng Bedfordview, Gauteng more than 14 days ago 10-08-2021 12:55:30 PM
05-10-2021 12:55:30 PM
Remuneration: Market Related

Related EE position: Non-EE/AA

Introduction

Medical claims administrator required with broad claims processing experience within medical aid or health insurance industry. Will be interacting with medical aids, hospitals, medical practitioners and patients.

Duties & Responsibilities

• Processing medical practitioners billing with supporting schedules and reporting
• Allocating payments
• ICD10 codes, RPL tariffs and medical procedures
• Submitting claims according to policy, benefits, rules for all practice types
• Assist team members with claims administration, improvements, data quality management and standard operating processes
• Assist with in-house training of new staff
• Handle correspondence and queries

Required Qualifications, Experience & Skills

• National Senior Certificate
• Knowledge of ICD10 codes, RPL tariffs, claims risk profiling and claim modifiers.
• Understanding of switching houses and bureaus electronic claims submissions
• Previous medical aid claims processing experience
• Computer literate
• Excellent verbal and written communication skills
• Detail orientated and a high level of accuracy
• Excellent customer service
• Minimum 3 years in a similar role