Claims Assessor

KEY WORK OUTPUT AND ACCOUNTABILITIES
- Assessing of all claims for all disciplines.
- Identify systems / processes enhancement and implementation.
- Management of the Service Level Agreements with medical schemes.
- Vendor documentation manage and administer.
- Assist in telephone queries.
- Give feedback to vendors on queries.
- Use system for updates.
- Interact with NOH team to assist with issues and data input.
- Keep claims administrator updated with escalations.
- Requires excellent communication skills - verbal and written.
- Actively participate as a member of a team to achieve goals.
- Keep up to date with Aloecrest’s evolving policies and procedures.
- Active involvement in own professional development to maintain a satisfactory level of skill and knowledge.
- Ensure professional conduct at all times.
- Work effectively and co-operatively with others to establish and maintain good working relationships that are mutually beneficial.
- Create and maintain a positive environment where the differences of others are recognized, understood, and valued, so that all can reach their full potential and maximize their contributions.
- Develop collaborative relationships to help accomplish work goal.

EDUCATION
- Grade 12 or equivalent to an NQF at level 4 qualification.

WORK EXPERIENCE
- Minimum of 3 years successful claims assessing experience within the Health Care Industry

KNOWLEDGE
- Claim assessing knowledge.
- Conversant with ICD 10 and CPT coding.
- Conversant with Modifiers and NHRPL.
- Conversant with Scheme Benefits.
- Accuracy, and Strong numerical ability.

**Job Types**: Full-time, Permanent

**Salary**: R18,000.00 - R27,000.00 per month

**Education**:

- Certificate (preferred)

Ability to Relocate:

- Hillcrest, KwaZulu-Natal: Relocate before starting work (preferred)