Medical Aid Claims Examiner
1 week ago
**About the Role**
Momentum, a leading health insurance company, is seeking an experienced Claims Assessor to join our team. As a Claims Assessor, you will play a crucial role in processing medical aid claims accurately and efficiently.
Key Responsibilities:
- Achieve high accuracy rates when capturing and processing incoming medical aid claims within agreed time frames.
- Collaborate with cross-functional teams in the claims department to ensure seamless claim processing.
- Process claims according to predetermined standards and business processes on the Oracle platform.
- Ensure claims validation is performed in accordance with legislation and scheme rules.
- Conduct quality control checks to minimize error rates.
- Analyze KRIS reports and departmental reports to identify trends and areas for improvement.
- Prioritize and manage multiple claims simultaneously to meet deadlines.
Requirements:
- Degree or equivalent qualification (Matric)
- Proficiency in computer systems and software (Computer literate)
- In-depth knowledge of medical aid assessing principles and industry regulations
- Working experience with the Oracle platform is advantageous
- Minimum 2-3 years' experience as a claims assessor or related field
- Familiarity with BHF, Tariff Guide, SAMA, ICD10 codes, and other relevant industry standards
-
Healthcare Claims Examiner
7 days ago
Durban, KwaZulu-Natal, South Africa Momentum Full timeJob Description: Healthcare Claims ExaminerWe are looking for a skilled Healthcare Claims Examiner to join our team. As a Healthcare Claims Examiner, you will be responsible for examining medical aid claims to ensure they meet the required standards.The ideal candidate will have:Matric qualificationComputer literacyComprehensive knowledge of healthcare...
-
Medical Aid Claims Analyst
7 days ago
Durban, KwaZulu-Natal, South Africa Momentum Full timeJob Title: Medical Aid Claims AnalystWe are seeking a skilled Medical Aid Claims Analyst to join our team. In this role, you will be responsible for accurately capturing and processing all incoming medical aid claims within agreed time frames.The ideal candidate will have:Matric qualificationComputer literacyComprehensive knowledge of medical aid assessing...
-
Claims Assessor and Medical Aid Specialist
1 week ago
Durban, KwaZulu-Natal, South Africa Momentum Full timeJob Overview">Momentum is seeking a skilled Claims Assessor to join our team in processing medical aid claims efficiently and accurately. The ideal candidate will have comprehensive knowledge of medical aid assessing procedures and experience working on the Oracle platform.Duties and ResponsibilitiesCapture and process incoming medical aid claims within...
-
Medical Claims Validator and Advisor
1 week ago
Durban, KwaZulu-Natal, South Africa Momentum Full timeJob Description">We are looking for a detail-oriented Claims Assessor to join our team at Momentum. As a key member of our claims department, you will play a crucial role in ensuring accurate and timely processing of medical aid claims.Your primary responsibilities will include:Capturing and processing incoming medical aid claims.Providing assistance to...
-
Senior Warranty Claims Examiner
2 weeks ago
Durban, KwaZulu-Natal, South Africa Barloworld Equipment (Pty) Ltd Full timeJob OverviewWe are seeking a highly skilled Senior Warranty Claims Examiner to join our team at Barloworld Equipment (Pty) Ltd. As a key member of our warranty team, you will be responsible for evaluating and processing all types of warranty claims against supplier warranty policies and guidelines.
-
Medical Aid Authorization Expert
7 days ago
Durban, KwaZulu-Natal, South Africa Dearx Full timeAbout Dearx:Dearx is a pioneering healthcare organization dedicated to providing innovative solutions and exceptional patient care. Our team of experienced professionals is committed to delivering high-quality services and exceeding customer expectations.Job Description:The Medical Aid Authorization Consultant will be responsible for authorizing ICD10 Codes,...
-
Healthcare Claims Processor
1 week ago
Durban, KwaZulu-Natal, South Africa Momentum Full time**About the Position**We are seeking a highly motivated and detail-oriented Claims Processor to join our dynamic team at Momentum Health. As a Claims Processor, you will be responsible for handling the assessment and processing of medical aid claims, ensuring accuracy, efficiency, and compliance with regulatory requirements.Key Responsibilities:*Accurately...
-
Claims Processing Specialist
7 days ago
Durban, KwaZulu-Natal, South Africa Momentum Full timeRole: Claims Processing SpecialistWe are seeking a skilled Claims Processing Specialist to join our team. In this role, you will be responsible for processing medical aid claims efficiently and accurately.The ideal candidate will have:Matric qualificationComputer literacyComprehensive knowledge of claims processing proceduresA minimum of 2-3 years'...
-
Healthcare Claims Processing Expert
1 week ago
Durban, KwaZulu-Natal, South Africa Momentum Full timeAbout the Role">Momentum is currently seeking a skilled Claims Assessor to join our dynamic team. As a Claims Assessor, you will be responsible for accurately capturing and processing medical aid claims, ensuring compliance with legislative requirements and scheme rules.Your Key Responsibilities will include:Receiving and processing incoming medical aid...
-
Claims Assessor MMH250402-2
1 week ago
Durban, KwaZulu-Natal, South Africa Momentum Full timeRole PurposeAssess and process medical aid claims as per Claims procedures.RequirementsMatricComputer literate.Comprehensive knowledge of all aspects of medical aid assessing is essential.Working on the Oracle platform is an advantage.A minimum of 2 - 3 years' experience as a claims assessor is an advantage.Industry knowledge (BHF; Tariff Guide; SAMA, ICD10...
-
Medical Claims Administrator
3 weeks ago
Durban, KwaZulu-Natal, South Africa Pillangó Placements Full timeMedical Claims AdministratorReference: PTA002871-CB-2We are looking for a Medical Claims Administrator for a big, amazing and innovative company in the health tech space.Duties & ResponsibilitiesThe purpose of the team that you will become part of is to launch a service-based solution driven by cutting-edge health tech, artificial intelligence, and debt...
-
Claims Assessor
1 week ago
Durban, KwaZulu-Natal, South Africa Momentum Full timeClosing Date: 2025/04/11Reference Number: MMH250402-2Job Title: Claims AssessorPosition Type: PermanentRole Family: Client ServicesCluster: Momentum HealthRemote Opportunity: None of the timeLocation - Country: South AfricaLocation - Province: KwaZulu-NatalLocation - Town / City: Durban, CornubiaIntroduction:Through our client-facing brands Momentum Group,...
-
Medical Claims Professional
3 days ago
Durban, KwaZulu-Natal, South Africa Pillangó Placements Full timePillangó Placements is seeking a skilled Medical Claims Administrator to join our team.About the Role:The successful candidate will be responsible for delivering an efficient, consistent, and accurate administrative medical debt service. This includes ensuring all claims are accurate before submission, clearing claim rejections, reconciling remittance...
-
Momentum Health Claims Specialist
1 week ago
Durban, KwaZulu-Natal, South Africa Momentum Full time**The Ideal Candidate**We are looking for a dedicated and results-driven Claims Specialist to join our team at Momentum Health. As a Claims Specialist, you will be responsible for assessing and processing medical aid claims, ensuring accuracy, efficiency, and compliance with regulatory requirements.Responsibilities and Requirements:Assess and process medical...
-
Durban, KwaZulu-Natal, South Africa Momentum Full timeJob Title: Claims Assessor">We are recruiting a qualified Claims Assessor to work with us at Momentum. In this role, you will be responsible for managing the entire claims lifecycle, from receipt to settlement.Your Main Responsibilities will include:Accurately capturing and processing medical aid claims.Supporting colleagues in the claims department as...
-
Medical Claims Administrator Position
3 days ago
Durban, KwaZulu-Natal, South Africa Pillangó Placements Full timeJob OverviewPillangó Placements is seeking a highly skilled Medical Claims Administrator to join our team. As a key member of our operations, you will play a crucial role in ensuring the smooth and efficient management of medical claims.
-
Insurance Claim Assessor
1 week ago
Durban, KwaZulu-Natal, South Africa Momentum Full time**Job Summary**Momentum Health is recruiting a skilled Claims Specialist to handle the assessment and processing of medical aid claims. This is a fantastic opportunity for an individual who is detail-oriented, organized, and possesses excellent communication skills.About Momentum Health:Momentum Health is a prominent player in the South African health...
-
Medical Claims Administrator
7 days ago
Durban, KwaZulu-Natal, South Africa Federated Employers Mutual Assurance Company (RF) Proprietary Limited (FEM) Full timeFEM is looking to appoint a Medical Claims Administrator in our Durban branch in the Claims Department. The overall objective of the position is to ensure that all registered claims are assessed and administered efficiently and effectively in terms of the Compensation for Occupational Injuries and Diseases Act. The position requires the incumbent to have...
-
Medical Claims Administrator Durban
3 weeks ago
Durban, KwaZulu-Natal, South Africa Pillangó Placements Full timeReference: PTA002871-CB-2We are looking for a Medical Claims Administrator for a big, amazing and innovative company in the health tech space.Duties & ResponsibilitiesThe purpose of the team that you will become part of is to launch a service-based solution driven by cutting-edge health tech, artificial intelligence, and debt management processes (primarily...
-
Remote Travel Expenses Examiner
7 days ago
Durban, KwaZulu-Natal, South Africa CHEP UK Ltd. Full timeSkillful and detail-oriented professionals are sought to fill the position of Remote Travel Expenses Examiner at CHEP UK Ltd.The ideal candidate will possess strong analytical skills, excellent written and verbal communication abilities, and experience working with high-volume complex data.Responsibilities will include:Auditing expense claims for compliance...