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Claims Quality Professional

2 weeks ago

Johannesburg, Gauteng, South Africa FNB Namibia Full time
Quality Assurance Role

We are looking for a skilled Claims Quality Professional to join our team. In this role, you will be responsible for ensuring the quality of medical claims processing and implementing identified quality methodologies and improvement initiatives.

Key Responsibilities:

  • Facilitating quality delivery and ensuring adherence to quality standards
  • Implementing identified quality methodologies and improvement initiatives
  • Monitoring quality adherence and compliance to quality standards
  • Providing ongoing intelligence on customers and competitors using internal and external data sources

Requirements:

  • Minimum Matric with experience in a similar role
  • Minimum 2-3 years of experience in medical claims processing, quality assurance, or risk assessment
  • Strong knowledge of medical insurance policies, claims procedures, and regulatory requirements