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Medical Billing Specialist
2 weeks ago
Last updated: 1 day ago
Job Description
We're seeking a highly skilled Medical Billing & Claims Processing Administrator to join our team.
As a key member of our healthcare team, you will be responsible for ensuring the smooth processing of patient claims and payments.
Your strong background in medical funder interactions, claims processing, and collections will enable you to make a real impact on our clients' business operations.
Responsibilities:
- Medical Billing & Claims Processing:
Review and process weekly hospital stats for billing accuracy.
Capture patient details and treatment codes into the system.
Submit and track claims via the in-house system.
Investigate and resolve claim rejections—resubmit where necessary.
Follow up on remittance advice and liaise with funders on rejected claims.
Ensure all necessary information is included for claim approvals. - Collections & Payments:
Generate and analyse age analysis reports weekly.
Maintain a summary spreadsheet to track outstanding accounts.
Follow up with funders, government institutions, or patients regarding outstanding payments.
Request and verify Proof of Payment (POP) from payers.
Reconcile received payments with system records and update accordingly.
Provide weekly reports on collections, expected payments, and outstanding debts.
Maintain proactive communication with funders to keep accounts up to date.
Requirements:
To succeed in this role, you should possess the following skills and qualifications:
Matric
2+ years experience in the relevant field
Experience in medical billing, claims processing, or collections.
Familiarity with Solumed or similar medical billing software.
Ability to handle funding queries and resolve claim disputes.
