Medical Aid Claims Administrator

3 weeks ago


Bedfordview, South Africa L.A.V. Full time

Our client, an IT software provider in the healthcare industry, is in search of a **Medical Aid Claims Administrator** to join their dynamic and fast-paced Admin department.
**Duties & Responsibilities**:

- Manage the Doctor’s account remotely.
- Reconcile remittances.
- Query outstanding claims.
- Resubmit outstanding claims.
- Maintain a low age analysis.
- Follow up on short payments.
- Flag claims regularly with updates.
- Clear Ontime rejections.
- Submit query reports to clients.
- Selecting correct scheme agreements.
- Maintain the ERA database.
- Identify tariff issues
- Constant liaison with client and logging of communication.
- General filing and admin.

**Requirements**:

- 3 years experience as a medical aid claims administrator.
- Deadline driven (Client turnaround time: 48 hours)
- Independent thinker; problem solver.

**Qualifications**:

- Matric certificate.

CTC includes Medical Aid and Provident Fund contribution.

**Salary**: R7,000.00 - R9,500.00 per month

Application Question(s):

- What is the difference between a tariff and an ICD-10 code?
- What makes a claim patient liable?

**Education**:

- High School (matric) (required)

**Experience**:

- Medical Aid Claims: 3 years (required)


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