Medical Aid Administrator

**Medical Aids Claims Administrator** Our client, a proudly South Africa-owned Audiology hearing healthcare company with a national footprint has a position open for a Medical Aids Claims Administrator in Pretoria East. **Role Description** This is a full-time, office-based position. The individual will be responsible for administrating claims and...

Our client, a proudly South Africa-owned Audiology hearing healthcare company with a national footprint has a position open for a Medical Aids Claims Administrator in Pretoria East. Role Description This is a full-time, office-based position. The individual will be responsible for administrating claims and authorisations from Medical Aids. Qualifications...

Our client, a proudly South Africa-owned Audiology hearing healthcare company with a national footprint has a position open for a Medical Aids Claims Administrator in Pretoria East. **Role Description** This is a full-time, office-based position. The individual will be responsible for administrating claims and authorisations from Medical Aids....

A reputable Medical Aid in Pretoria is seeking an experienced DUR Administrator to join their team. **Requirements**: - Grade 12 - Administration Certificate/Diploma (Advantage) - Minimum 1-year administrative role in the Medical Scheme or related environment - Minimum 1-year Medical Schemes Act, related legislation and managed healthcare exposure - Credit...

TWK Agri has the following vacancy available: Broker (Medical-Aid) within the Insurance Department in Pretoria, Gauteng. **Responsibilities and Duties** - Introduction of new business and maintenance of existing business - Assisting clients to find the most appropriate medical aid cover based on an assessment of their needs - Weekly/Monthly reporting -...

Responsible for continuous marketing and relationship buiding.Prepare quotations and change of broker letters for new clients Assist with queries and claims and provide timeous feedback Manage and retain current Medical Aid Funds Provide companies. Degree/Diploma (NQF5 Wealth Certification) Class of business completed CMS Accredited RE 5 At least 2...

The purpose of this position is to ensure that all claims are assessed using the appropriate rules and is paid correctly in line with the Scheme's benefit and tariff structures. **Duties**: - Assessing and processing Medical Aid claims - **Quality**:Measuring of individual error rate to ensure no costs incurred due to assessing errors made. -...

A reputable Medical Aid is seeking an experienced DUR Pharmacist to join their team in Pretoria. **Duties**: - Medicine authorisations as per Scheme rules and protocols to ensure cost-effective reimbursement of medicine and medicine cost containment. - Ensure medicine benefit allocations are applied and executed correctly according to Scheme...

A reputable Medical Aid is seeking a Junior PMB Clinical Assistant to join their Pharmaceutical Benefit Management Department in Pretoria. Please note, this is an office-based role. **Duties**: - Administration of PMB and CDL treatment plan authorisations. - Managing PMB referrals and the Supervisor escalation inbox. - Daily stats report. - Providing...

Medical Billing Bureau in Lynnwood Manor (Pretoria East) is excited to offer an employment opportunity to an experienced Medical Billing Administrator. Minimum requirements to apply: - Driver's license (ESSENTIAL). - Matric/Grade 12 qualification (ESSENTIAL). - 2 years Physiotherapy or Occupational Therapy billing experience (ESSENTIAL). - Computer skills...

Our client, a managed care organisation based in Pretoria is looking for a Call Centre Agent. This is an equal opportunity organisation with various businesses and/ or subsidiaries that service clients in the medical scheme and insurance industries. Position: Medical Call Centre Agent - Adding or removing of dependants - Processing medical scheme membership...

reputable Medical Aid is seeking a Junior PMB Consultant to join their team in Pretoria. **Duties**: - Administration of PMB and CDL treatment plan authorisations - Managing PMB referrals and supervising escalation inbox - Daily stats reporting - Supporting the Manager/Team Leader and other Managers in tasks and initiatives beneficial to the teams and to...

A reputable Medical Aid based in Pretoria is seeking a Regional Service Consultant to join their team. **Duties**: - Service delivery to all stakeholders in specific regions. (These include Members, Advisors, Providers and Suppliers in accordance to prescribed processes) - Coordinating the functions and logistics of the regional office and responsible for...

A reputable Medical Aid based in KZN is seeking a Regional Service Consultant to join their team. **Duties**: - Service delivery to all stakeholders in specific regions. (These include Members, Advisors, Providers and Suppliers in accordance to prescribed processes) - Coordinating the functions and logistics of the regional office and responsible for all...

TWK Agri has the following vacancy available: Broker (Medical-aid) within the Insurance Department in Pretoria, Gauteng. **Salary**:Basic salary, perks and commission **Responsibilities and Duties**: - Introduction of new business and maintenance of existing business - Assisting clients to find the most appropriate medical aid cover based on an assessment...

Billing controller must have experience working with medical claims, ICD 10 and procedure codes. Must have GoodX experience. Person must have experience with IOD claims and Compeasy website. **Salary**: From R15,000.00 per month Ability to commute/relocate: - Pretoria, Gauteng: Reliably commute or planning to relocate before starting work...

A reputable Medical Aid is seeking a Rules & Tariff Master to join their Claims Department. This role will ensure that the tariffs and rules are loaded correctly on the Administration System and to maintain this function with regards to updates and changes. **Duties**: - Providing effective communication to staff and Management on changes in the industry,...

A reputable Medical Aid is seeking a Dental Administrator to join their Hospital Benefit Management team in Pretoria. Please note: This is an office-based role. **Job Purpose** To improve overall operational efficiency and ensure an optimal member experience by assisting with dental authorisations, enquiries and feedback. **Summary of duties** - Client...

A reputable Medical Aid based in Pretoria is seeking an experienced DUR Pharmacist to joint their team in Pretoria. **Requirements**: - Grade 12 - B.Pharm Degree - Registered with South African Pharmacy Council (SAPC) - Minimum 2 years experience in Drug Utilisation Review (DUR) and administrative processes **Job Types**: Full-time, Permanent Application...

A reputable Medical Aid based in Pretoria is seeking a Case Manager to join their HBM team. **Job purpose**: - Delivering a cost-effective Managed Healthcare service to accomplish member satisfaction. **Qualification / Experience**: - Grade 12 / Matric - B Cur Degree or Diploma in Nursing - SANC Registered - A minimum of 5 years' experience as a Nursing...