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Pre-Payment Claims Validator
3 weeks ago
We are looking for a skilled Pre-Payment Claims Validator to join our team at Recruitmymom.
In this role, you will be responsible for conducting thorough pre-payment claim audits to identify potential discrepancies, inaccuracies, and fraud risks before payment is processed.
Key Role- Conduct regular audits of processed claims to identify potential issues and areas of improvement.
- Manage a list of high-risk claimants and conduct thorough investigations before payment is approved.
- Perform sample audits on other claims to detect anomalies and ensure compliance with policy terms.
- Identify potential fraudulent claims, abuse, and overbilling before payments are made.
- Escalate high-risk claims to the risk and legal departments for further investigation and analysis.
- Stay updated on industry fraud trends and emerging risk mitigation practices.
- Opportunity to work with a dynamic team committed to risk management and operational efficiency.
- Hybrid working arrangement for JHB based candidate.
- Fixed term contract with a focus on specialised expertise.
