Medical Claims Administrator

2 weeks 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

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