Medical Claims Auditor

At Recruitmymom, we're seeking a highly skilled Medical Claims Risk Analyst to join our team on a hybrid, 6-month fixed-term contract.This role is a proactive safeguard against fraudulent or invalid claims, reducing financial exposure to the organisation. You will be responsible for conducting detailed pre-payment claim audits to identify suspicious claims,...

Job Location : Gauteng, JohannesburgDeadline : April 05, 2025RequirementsMatric / Grade 12Basic medical qualification an advantage (e.g. nursing or similar qualification)Computer Literacy (MS Word, Outlook and Excel)FAIS Fit and Proper including RE5At least 2 years medical aid or gap cover claims processing and assessing experienceAt least 1 year insurance...

Job DescriptionWe're looking for… Are you an experienced Medical Billing & Collections Administrator looking for a role where your attention to detail and organizational skills make a real impact?Join our clients' healthcare team and play a vital role in ensuring the smooth processing of patient claims and payments.If you have a strong background in...

We need an Insurance Claims Reviewer to join our team at Recruitmymom.This role involves reviewing insurance claims to ensure they meet the required standards and policies.Key ResponsibilitiesReview insurance claims to detect discrepancies, inaccuracies, and potential fraud.Manage a list of high-risk claimants and conduct thorough investigations before...

Ellahi Consulting is seeking a highly skilled Senior Auditor to join our team. The successful candidate will be responsible for ensuring compliance with tax laws and regulations, preparing and submitting Tax/VAT returns, and reviewing revenue authority Statements of Account.Ensure Tax/VAT returns are prepared and submitted for review prior to submission to...

Job Summary: A healthcare facility is seeking a Billings Auditor to ensure accurate and efficient billing processes while maintaining high standards of patient care and compliance. The role involves auditing patient files, managing billing systems, and optimizing revenue in line with contractual agreements.Minimum Qualifications & Experience:Diploma in...

Company DescriptionAbout KaeloKaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change. Kaelo meets the Healthcare needs of Corporate and Retail clients across South Africa – products offerings include Medical Insurance, Medical Aid, Gap Insurance, Kaelo Money and...

**Job Description:**We are seeking a highly skilled Medical Biller Collector to join our team at ISTA Solutions. As a key member of our operations, you will play a vital role in ensuring the smooth processing and collection of medical claims.**Key Responsibilities:**Patient Payment Collection: Follow up with patients to collect payments, establish payment...

**Job Title:** Remote Medical Collections ProfessionalWe are seeking a highly motivated and organized individual to fill the role of Remote Medical Collections Professional at ISTA Solutions. As a key member of our team, you will be responsible for collecting payments from patients, reviewing and resolving claims, and verifying patient...

Our client, a non-profit medical scheme, is seeking an HBM: Clinical Hospital Auditor for the Pretoria area.Behavioural Competencies:Analytical thinkingAssertiveCaring and ConfidentEmotional maturityFlexibleHonest approachPerceptive and professional behaviourSelf-motivated and Open-mindedDuties:Duties include but are not limited to delivering cost-effective...

Dymaxa Recruitment is a leading provider of recruitment services to the healthcare industry. We are currently seeking a highly skilled Medical Funding Professional to join our team.About the Position:As a Medical Funding Professional, you will be responsible for pre-authorising treatments and ensuring that our clients receive the best possible...

GJM Ultra Billing is seeking a highly skilled Credit Controller to join their team. The ideal candidate will have previous experience in medical billing and credit control, with a strong understanding of billing systems, private medical insurance plans, and reimbursement methods.Key Responsibilities:Support the billing process for insured and self-pay...

Medical Billing SpecialistMasa Outsourcing (Pty) Ltd is hiring a Medical Billing Specialist to become part of their dedicated team in the health sector.Main Duties:Ensure accurate and timely processing of medical claims.Effective management of patient billing and payment systems.Collaborate with healthcare providers to resolve billing queries.Stay up-to-date...

Medical Aid Administrator / Sales Consultant – Johannesburg.Kickstart Your Career in Medical Aid Administration & SalesWe are looking for a dynamic and results-driven Medical Aid Administrator & Sales Consultant to join our team in Lanseria. If you have strong sales skills, experience in medical aid administration, and a passion for helping clients find...

Job Description:RequirementsWe are looking for a highly skilled Medical Billing Collections professional with excellent customer service skills.The ideal candidate should have a strong understanding of US healthcare, billing terms, and processes.RequirementsCustomer Service with a collections background.Skilled in MS Office (Word) and Outlook.Strong work...

ISTA Personnel Solutions South Africa is a leading global BPO company partnering with a U.S.A Medical Billing Company. We are seeking an experienced Medical Billing Collections professional to handle U.S. healthcare insurances such as Medicare, Medicaid etc.To excel in this role, a strong understanding of US healthcare, billing terms, and processes is...

Job DescriptionWe are seeking an experienced Medical Aid Administrator & Sales Consultant to join our team in Lanseria. As a key member of our sales team, you will be responsible for assisting clients with medical aid applications, renewals, and amendments, as well as managing claims processing and liaising with medical aid providers.You will work closely...

Job Purpose: We pride ourselves on our superior customer experience for all our customers, whether internal or external, by applying the highest technical claims knowledge and systems understanding when resolving claims and providing support within the company.Our area of expertise consists of building claims.The inherent goal is to consistently exceed...

Key ResponsibilitiesAssist clients with medical aid applications, renewals, and amendmentsManage claims processing and liaise with medical aid providersMaintain accurate policy documentation and ensure compliance with industry regulationsIdentify, engage, and convert potential clients into medical aid policyholdersCold call, follow up on leads, and generate...

About the PositionThe Hiring House is looking for an experienced Claim Manager to join our team. This individual will be responsible for overseeing the provision of social services to guardian cases, implementing Benefits Committee & Medical Panel decisions, and requesting referrals for case investigations and social advice from other internal...