Medical Claims Negotiator

We’re looking for… A Provider Contracting and Negotiating Specialist who will be responsible for working on behalf of the client to negotiate their out of network claims when applicable. You will work directly with out of network providers to work out a single case agreement/fee or direct contract for submitted medical claims. Who are you? - You can...

We're looking for a skilled professional to join our team at HR Studio as an Out-of-Network Claims and Negotiations Coordinator.This role involves working with out-of-network providers to negotiate fees and rates, ensuring cost-effective service delivery. The ideal candidate will have excellent communication skills, be able to make informed decisions, and...

We are seeking a skilled Medical Claims Examiner to join our team at HR Studio.The ideal candidate will have a strong background in medical claims processing and be able to analyze claims to identify key elements and processing requirements.The Claims Processing Specialist will be responsible for reviewing assigned claims or requests from a queue,...

We are seeking an experienced Medical Claims Specialist to join our team at HR Studio Ltd. The ideal candidate will possess excellent analytical skills and have a strong understanding of medical terminology.The Medical Claims Specialist role involves processing medical claims efficiently and accurately, ensuring timely adjudication and resolution of pending...

Job Title: Medical Claims AdjudicatorAbout the Role:We are seeking a skilled Medical Claims Adjudicator to join our team at HR Studio Ltd. The successful candidate will be responsible for the timely and accurate processing and adjudication of medical claims.Key Responsibilities:- Review assigned claims or requests from a queue and maintain a set inventory...

We're seeking a skilled Medical Claims Examiner to join our team at HR Studio. As a Claims Analyst, you will be responsible for providing timely and accurate processing and adjudication of claims.About the RoleYou will be part of a dynamic team responsible for reviewing assigned claims or requests from a queue, maintaining a set inventory level. Your key...

Job Title: Medical Claims ExaminerWe are seeking a highly skilled Medical Claims Examiner to join our team at HR Studio Ltd. As a Medical Claims Examiner, you will be responsible for the timely and accurate processing and adjudication of claims.Key Responsibilities:Review assigned claims or requests from a queue, maintaining a set inventory level.Analyze...

**Job Title:** Medical Claims ExaminerAbout the Role:We are seeking a highly skilled Medical Claims Examiner to join our team at HR Studio Ltd. As a Medical Claims Examiner, you will be responsible for the timely and accurate processing and adjudication of medical claims.Key Responsibilities:Review assigned claims or requests from a queue, maintaining a set...

About the RoleWe're seeking a highly skilled and experienced Senior Medical Claims Specialist to join our team at HR Studio. This is a challenging opportunity for an individual with excellent negotiation and communication skills to work closely with out-of-network providers to secure cost-effective service delivery.

About the Role:We are seeking a highly skilled Claims Analyst to join our team at HR Studio Ltd.The ideal candidate will have extensive experience in medical claims processing, including knowledge of medical terminology and working in a production environment.Key Responsibilities:Review assigned claims or requests from a queue, maintaining a set inventory...

Senior Medical Assessor RoleThe successful candidate will be responsible for managing claims in accordance with policy terms and conditions. They will be accountable for claims processes and procedures, and will work with stakeholders to develop return to work plans as needed. The ideal candidate will have a strong understanding of claims management and will...

We are seeking a skilled Recoveries Negotiator to join our Hollard Insure, Specialised Claims Services Department (Operations) on a fixed-term contract basis.Key Responsibilities:Manage end-to-end negotiation and settlement of recovery motor and non-motor claims.Ensure operational effectiveness and profitability in claim management.Effectively manage costs,...

**Introduction** Processing of medical expense shortfall (gap cover) claims in accordance with stipulated service levels and in terms and conditions of cover as defined in policy wording. **Role Purpose** Processing of medical expense shortfall (gap cover) claims in accordance with stipulated service levels and in terms and conditions of cover as defined...

We’re looking for… A Claims Analyst that will provide timely and accurate processing and adjudication of claims. You will be doing research and processing claims or related requests for covered members or providers across various products including medical, pharmacy, vision, and related healthcare options. Who are you? - You know how to communicate...

**EXEPERIENCE IN THE FINANCIAL SERVICES INDUSTRY/LIFE INSURANCE ESSENTIAL** - Responsible to drive the formulation and implementation of the risk model and underwriting philosophy, analyse claims and other data when assessing claims. - Providing feedback on all claims, liaising with relevant stakeholders, and utilise their skills, knowledge, and experience...

We're looking for… A Claims Analyst that will provide timely and accurate processing and adjudication of claims.  You will be doing research, and processing claims or related requests for covered members or providers across various products including medical, pharmacy, vision and related healthcare options.  Who are you? ...

Gauteng, Sandton - Annually Cost To Company (Market related, Negotiable) The claims controller will collate records and examine information to assist in determining claim settlements, within the governed framework to ensure compliance with the short term insurance regulations. OR to determine the validity of the claims from agent companies, assess the...

Oversee and manage the entire claims process, from initial assessment to final settlement. Ensure that all claims are handled efficiently and in accordance with PPS Short-Term Insurance Company's policy terms and conditions. Administer and validate claims correctly, utilizing negotiation and settlement skills to resolve conflicts and achieve successful...

**Business Unit**:Discovery Employee Benefits**Function**:Claims Administration**Date**:4 Oct 2024 - Achieve more than** **YOU BELIEVE** - Discovery Corporate & Employee Benefits- Claims and Underwriting Administrator**About Discovery** - Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in...

Co-ordinate and oversee, manage negotiate and settle personal lines and commercial claims and account for the finalisation of the claim end-to-end. Delegate authority to manage the process and resolve any conflict by a negotiating, settlement, and finalisation functionality. Administer and validate claims correctly and efficiently within the specifications...