Medical Claims Examination Expert

As a Healthcare Claims Examiner, you will play a vital role in ensuring that claims are processed efficiently and accurately. Your expertise will be utilized to review medical reports and medical investigation reports, as well as to evaluate treatment authorisation requests.About the TeamYou will be part of a dedicated team that values teamwork and...

Job Summary: We are seeking a skilled Insurance Claims Examiner to join our team at Rand Mutual Admin Services. As a key member of our claims department, you will be responsible for the effective and efficient processing of insurance claims.Main Responsibilities:Verify claims for correctness and compliance with prescribed guidelines.Capture additional...

We are seeking a highly skilled Medical Adjudication Expert to join our team at Rand Mutual Admin Services. As a Medical Adjudication Expert, you will be responsible for reviewing medical reports and medical investigation reports, as well as evaluating treatment authorisation requests.About the JobThe role requires an individual with critical thinking that...

**Role**:Claims Examiner **The Organisation**: The organisation is the largest underwriter of corporate property and affiliated engineering risks in South Africa, and underwrites business throughout Africa. **Minimum Requirements**: - At least 5 years’ experience in corporate / commercial property and business interruption claims handling - In-depth...

What will you do? Emerald a subsidiary of Santam has a position available for a Claims Examiner who will be based in Fourways, Johannesburg. What will you do? Management and administration of claims in terms of corporate Assets All Risk Property Damage and Business Interruption claims Appointment and management of external resources e.g., loss adjusters,...

Santam Insurance is seeking a skilled Motor Merit Claims Examiner to examine and process claims efficiently and effectively.About the JobConduct thorough examinations of claims to ensure accuracy and completeness.Interact with customers to clarify any discrepancies.Develop and maintain relationships with external stakeholders.ResponsibilitiesExamine claims...

Provide an efficient and professional Claims service to customers through prompt and fair settlement of Claims within mandate. Contribute to business development and retention through positioning Claims and Claims service as an AIG product. **PRINCIPLE DUTIES AND RESPONSIBILITIES**: Claims Administration Register the Claim according to procedure Set...

Our client is looking for the assistance of Freelance/Temporary Medical Aid Claims Administrator. - Grade 12 or equivalent qualification - Knowledge if clinical codes e.g. ICD, CPT etc. - Knowledge of medical aid schemes and medical aid claims procedures and a good understanding of PMB legislation. Gap cover claims experience is an advantage. - Have...

Introduction: As a Claims Assessor, you will be reporting to the Team Leader: Claims Assessor. You will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance. Description: THE JOB AT A GLANCE As a Claims Assessor, you will be reporting to the Team Leader:...

Introduction: As the Clinical Claims Adjudicator, you will be reporting to the Team Leader: Clinical Claims Adjudication. You will be responsible for providing support on the effective and efficient adjudication of disease and accident claims in line with COID Act and Non-COID VAPS policies. Description: THE JOB AT A GLANCE As the Clinical Claims...

Role Summary:This role involves handling claims related to funerals, ensuring that they are processed efficiently and effectively. The successful candidate will have excellent analytical skills, attention to detail, and strong communication skills.Key Responsibilities:Analyse and assess claims to determine validity and ensure timely payment. Detect and...

**THE JOB AT A GLANCE** As the Claims Assessor, you will be reporting to the Team Leader: Claims Assessor. You will be responsible for adjudicating and processing claims in an effective and efficient manner within the prescribed guidelines set out by Rand Mutual Assurance. **WHAT WILL YOU DO?** **Claims Adjudication**: - Verify claims captured for...

**Job Overview**Rand Mutual Admin Services is seeking a skilled Clinical Claims Specialist to join our team. In this role, you will be responsible for providing critical support in the effective and efficient adjudication of disease and accident claims.About the RoleReview and update ICD10 codes on all claims in line with relevant protocols and accepted...

SENIOR COMPLEX CLAIMS EXAMINER Who we are American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience, today AIG member companies provide a wide range of property casualty insurance, life insurance, retirement solutions, and other financial services to customers in more than 80 countries and...

As a Medical Claims Specialist with Qetello Holdings in Johannesburg, you will play a crucial role in assisting our client, a leading claims administrator in the area, with Private and medical aid claims.Key ResponsibilitiesImplement credit control procedures for specialist doctors and Allied Professionals in accordance with our credit control/debt...

Job OverviewWe are seeking a skilled Medical Claims Auditor to join our team. This is an exciting opportunity for a highly motivated individual with a strong clinical background and exceptional analytical skills.In this role, you will be responsible for conducting detailed pre-payment claim audits to identify suspicious claims, ensure accuracy, and mitigate...

Ista Solutions is a leading BPO company partnering with a U.S.-based healthcare client.We seek an experienced and professional Medical Claims Processor with a strong background in the U.S. healthcare industry to join our remote team.About the Role:This position requires extensive knowledge of U.S. medical billing software and a strong understanding of U.S....

**Gauteng**, JHB - North** **R 16000 - R 17000 Monthly Cost To Company** We are looking for a **Medical Claims Administrator** for a big, amazing and an innovative company in the health tech space. The Purpose of the team that you will become part of, is to launch a service based solution which is driven by back of cutting edge healthtech, artificial...

TalentCru Job OpportunityWe are looking for a seasoned Senior Claims Assessor to join our team in the telecommunications industry. In this role, you will be responsible for assessing and processing complex claims, ensuring timely and accurate resolutions.Key Tasks:Evaluating claims against stipulated criteriaResolving client queries and complaints...

TBU - We are an Equal Opportunity Employer - American International Group, Inc., its subsidiaries and affiliates are committed to be an Equal Opportunity Employer and its policies and procedures reflect this commitment. We provide equal opportunity to all qualified individuals regardless of race, color, religion, age, gender, gender expression, national...