Medical Credit Controller

7 months ago


Johannesburg, South Africa Qetello Holdings Full time

Together with our client, a leading claims administrator in Johannesburg South, we are recruiting for a Medical Credit Controller to assist with Private and medical aid claims.

**Duties and Responsibilities**:

- Implement credit control procedures for specialist doctors and Allied Professionals in accordance with our credit control/debt collection policy
- Experience in collecting payments for specialist patient accounts with medical aids, with proficiency in at least four of the following specialties: Surgery, Gynaecology, Paediatrics, Urology, Physiotherapy, General Practice (GP), Physician and Psychiatry.
- Follow up with medical aids to ensure prompt payment of outstanding claims.
- Monitor and follow up on claims related to Prescribed Minimum Benefits (PMB), providing relevant documentation as required.
- Collect payments directly from patients for accounts where they are liable.
- Perform daily reconciliation of Electronic Remittance Advice (ERA) and bank statements.
- Obtain and input manual Remittance Advices (RA)
- Resolve rejections from medical aids and upfront claim rejections
- Submit paper claims when electronic submission is not possible
- Provide timely responses to inquiries from both medical practices and patients
- Follow the handover process once the collection process is completed
- Perform any additional duties as requested by supervisors and management

**Qualifications and Experience**:

- Matric / Grade 12
- Credit Control/debt collection within a medical bureau, performing collections on specialist doctors patient accounts
- CPT 4 Code experience
- Tariff code experience
- ICD 10 Coding experience
- Valid driver’s license and own vehicle

**Skills and Competencies**:

- Computer literate in MS Office (Microsoft Excel, Word, and PowerPoint; and Outlook)
- Articulate with strong communication skills (oral and written)
- Ability to adapt and learn new skills.
- Ability to multitask.
- Cope well under pressure.

**Remuneration**
- R 15 000.00 - R19 000.00 CTC per month depending on experience
- Yearly bonus - target based
- 15 Days holiday, with 2 additional holiday days for every 5 years’ service completed
- Team building fun day once a year
- Yearly salary increase based on performance


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