Medical Claims Administrator

4 days ago

Johannesburg, South Africa Pillango Placements Full time

**Gauteng**, JHB - North**

**R 16000 - R 17000 Monthly Cost To Company**

We are looking for a **Medical Claims Administrator** for a big, amazing and an innovative company in the health tech space.

The Purpose of the team that you will become part of, is to launch a service based solution which is driven by back of cutting edge healthtech, artificial intelligence and debt management processes (primarily focused on the private medical specialists market). You will focus strongly on client delivery and at the same time make a difference in the lives of Drs and patients alike. You will deliver an efficient, consistent and accurate administrative medical debt service, provide the Doctors with monitoring and bureau reports that will allow him/ her to have real time data on the financial status of the practice. You will become his/ her trusted business partner ensuring that his cash flow is timous and that his/ her aged debt is at a minimum.

**Duties**:

- Ensure that all claims are accurate before they are submitted to the medical schemes
- Clear claim rejections as soon as you are notified.
- Reconcile and monitor all remittance advices
- Select correct scheme agreements so that the client is able to post the correct rates annually
- Follow - up on all outstanding claims
- Re-submit outstanding claims that need fixing
- Maintain a low age analysis if not zero
- Follow up on short payments
- Follow up on claims regularly with valid updates at each point of query
- Keep constant communication open with the practice and the client
- Build and maintain relationships with clients
- Monitor and maintain doctors databases with the assistance of BI reporting

**Qualifications and Skills**:

- Matric and relevant administrative qualification
- G-Suite Experience is advantageous
- 2-3 years Industry knowledge
- Must have knowledge on PMB’s
- Customer Service Orientated
- Initiative and Commitment to Achieve
- Attention to Detail and Quality
- Teamwork Orientated
- Excellent Communication Skills
- Diplomacy
- Presentation Skills
- Adaptability
- Analytical Thinking
- Continuous Learning

  • Medical Billing Specialist

    1 week ago

    Johannesburg, South Africa Forte Medical Solutions Full time

    We are looking for Medical Accounts Specialist to be based in Randburg, Johannesburg. **Must have **extensive experience in medical billing and coding **Must Have’s**: - Medical accounts credit control experience - Medical claims data capturing - High attention to detail - Excellent Telephone communication skills - Target driven and highly motivated -...

  • Medical Claims Assessor

    4 days ago

    Johannesburg, South Africa Prism Placements Full time

    Experience & Requirements:Matric / Grade 12.Min 3-4yrs experience dealing with medical aid claims for customers a MUST.Excellent verbal and written communication skills. Remuneration:Up to R264K C.T.C. per annum Location:Sandton

  • Medical Claims Assessor

    3 days ago

    Johannesburg, South Africa Prism Placements Full time

    Experience & Requirements:Matric / Grade 12. Min 3-4yrs experience dealing with medical aid claims for customers a MUST. Excellent verbal and written communication skills. Remuneration:Up to R264K C.T.C. per annum Location:Sandton

  • Medical Advisor

    2 days ago

    Johannesburg, South Africa Medical Placements Full time

    **Role Purpose** To provide a medical advisory function within the Clinical Risk Division and Scheme to ensure the limiting of the Scheme’s exposure and to inform key strategic decisions. **Key Areas of Responsibility** Provide input into the development of the sub-division’s strategy. Provide input into the tactical plan for the Clinical Risk...

  • Junior Finance Administrator

    2 weeks ago

    Johannesburg, Gauteng, , South Africa Quro Medical Full time R250 000 - R400 000 per year

     Junior Finance Administrator Finance – Sandton, Gauteng Quro Medical is a digital health company pioneering Africa's first and largest virtual hospital, delivering high-quality care to patients in the comfort of their homes. By combining technology, data, and clinical expertise, we're redefining the future of healthcare across the continent. Role...

  • Senior Claims Administrator

    4 weeks ago

    City of Johannesburg Metropolitan Municipality, South Africa Ambledown Financial Services Full time

    We are seeking a Senior Claims Administrator with strong clinical background to join our team. Qualifications Clinical or Nursing Diploma/Degree. SANC Registered. FAIS Compliant (advantageous). Skills and Experience At least 2 – 3 years’ gap cover claims experience. Technical knowledge of various health insurance products. Advanced knowledge of ICD...

  • Claims Administrator

    1 week ago

    Johannesburg, South Africa RAD Resources Full time

    Opportunity for a at Johannesburg North Insurance Brokerage. Play a crucial role in restoring our clients to their pre-loss status. Be the driving force behind efficient claims management, ensuring adherence to the companies service standards and swift turnaround times. Make a difference by helping clients navigate the complexities of the claims process and...

  • Senior Claims Administrator

    3 weeks ago

    Johannesburg, South Africa Ambledown Financial Services Full time

    We are seeking aSenior Claims Administratorwith strong clinical background to join our team. Qualifications Clinical or Nursing Diploma / Degree. SANC Registered. FAIS Compliant (advantageous). Skills and Experience At least 2 – 3 years' gap cover claims experience. Technical knowledge of various health insurance products. Advanced knowledge of ICD Codes,...

  • Claims Administrator

    2 weeks ago

    Johannesburg, South Africa FirstRand Full time

    Job Description To manage the claim from notification to completion as well as support the claims assessor in their core function and other internal and external customers Hello Future Administrator Welcome to FNB, the home of the #changeables. We design for the shapeshifters and deliver products and services that make us incredibly proud of people that...

  • Claims Administrator

    2 weeks ago

    Johannesburg, South Africa Hollard Insurance Full time

    About the Role Join to apply for the Claims Administrator (Lumkani) role at Hollard Insurance Hello… an exciting new opportunity has just become available at Lumkani, an affiliate of Hollard . We are looking to recruit an experienced Claims Administrator , who is detail‑oriented, organised and able to manage work efficiently while delivering...