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Prescription Claims Resolution Specialist
2 weeks ago
Job Summary:
The successful candidate will be responsible for resolving medical aid rejections and ensuring that our customers receive their prescribed medications on time. This involves working closely with medical schemes, pharmacies, and patients to resolve queries and resubmit claims.
Key Responsibilities:
- Resolving medical aid rejection queries with members where the medical aid has no impact
- Resolving medical aid rejection queries with medical schemes
- Providing members with status updates regarding rejections and their resolutions
- Resubmitting all rejections within the target set per medical aid
- Resolving queries received from patients within a two-hour turnaround time
Requirements:
- Degree/Diploma in a relevant field or equivalent experience
- Knowledge of IT applications, including Marconi, Phoenix, and Exsol
- Familiarity with pharmacy legislation and product knowledge
- Excellent analytical, decision-making, and communication skills
About Us:
We are a leading retail pharmacy group in South Africa, committed to providing quality healthcare services to our customers. Our team is passionate about delivering exceptional results and making a meaningful difference in people's lives.
Benefits:
We offer a competitive salary, comprehensive benefits package, and opportunities for career growth and development. If you are a motivated and results-driven individual who is passionate about risk management and customer service, we encourage you to apply for this exciting opportunity.
