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Medical Aid Claims Assessor
3 weeks ago
A reputable Medical Aid is seeking an experienced Medical Aid Claims Assessor to join their HBM team in Pretoria. (Office based)
**Requirements**:
- Grade 12
- Staff/Enrolled or Registered Nurse (SANC)
- Minimum 5 years’ experience as a Nursing Practitioner
- Minimum 1 year experience gained in the medical funding industry
- 1 year Medical Aid claims auditing experience **(Essential)**
**Duties**:
- Delivering cost effective managed healthcare service to accomplish member satisfaction.
- Ensuring that hospital accounts are audited in accordance with the Scheme's rules, guidelines and the different Hospital contracts.
- To ensure that hospital accounts are assessed in accordance with the Scheme's rules, guidelines and the different hospital contract, within the turnaround time.
- Paper claims assessment.
- Measuring individual error rate to ensure no costs incurred due to assessing errors made.
**Job Types**: Full-time, Permanent
**Salary**: R1.00 - R2.00 per month
Application Question(s):
- Where have you previously worked as a Clinical/Medical Claims assessor?
- What is your minimum salary expectation? (Before deductions)
**Education**:
- Certificate (required)
**Experience**:
- Nursing: 5 years (required)
License/Certification:
- SANC (required)
Ability to Relocate:
- Pretoria, Gauteng: Relocate before starting work (required)
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