Medical Bureau Claims Administrator

18 hours ago


Durban, South Africa Pillango Placements Full time
As a Medical Claims Administrator, you will be required to deliver an efficient , consistent and accurate administrative medical debt service to clients. You will also provide the Doctors with monitoring and bureau reports that will allow them to have real time data on the financial status of their practice. You will become a trusted business partner ensuring that their cash flow is timeous and that aged debt is at a minimum.

Key Responsibilities:
  • Capture patient demographics and claims accurately.
  • Ensure that all claims are accurate before they are submitted to the Medical Schemes
  • Clear claim rejections as soon as notified.
  • Reconcile and monitor all remittances.
  • Follow-up on all outstanding claims.
  • Correct/resubmit claim rejections.
  • Maintain a low age analysis.
  • Follow up on short payments.
  • Follow up on claims regularly with valid updates at each point of query.
  • Keep constant communication open with the practice and the client.
  • Build and maintain relationships with clients.
  • Monitor and maintain doctors' databases.
Qualifications and Experience
  • Matric
  • A relevant administrative qualification is advantageous
  • 2 to 3 years industry experience is essential
  • Must have knowledge on PMBs
Knowledge and Skills
  • Must have knowledge on PMBs
  • High level of computer literacy
  • High level of numeracy
  • Google Workspace experience is advantageous
NOTE: Please apply online. Due to large volumes, we are unable to consider direct applications via Whatsapp or email.

The final remuneration package offered by the employer will be determined based on market standards, considering the candidate's qualifications, skills, and level of experience. The employer retains the prerogative to provide a remuneration package that aligns with industry norms and the specific attributes of the selected candidate.

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