You will be responsible for assessing, reconciling and recovering as much as possible from new clients outstanding past accounts. This will ensure that all outstanding accounts are reflected correctly and the correct claim statuses are applied in
order for the client to make informed decisions to write off or hand over.
Description
- Assess and reconcile all outstanding claims to ensure the balances are accurately represented on the system.
- Attend to claim rejections to resolve and attempt to maximise payment received from medical schemes.
- Retrieve, reconcile and monitor all remittance advices.
- Follow-up on all outstanding claims.
- Identify any incorrect billing to fix and resubmit claims accordingly.
- Reduce the total outstanding balance in the age analysis by focusing on collections and reconciliation.
- 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.
- Monitor and maintain doctors databases with the assistance of BI reporting.
Job Requirements
Qualifications and Experience
- Matric
- Relevant administrative qualification is advantageous
- 2 - 3 years industry experience is essential
Knowledge and Skills
- Google Workspace experience is advantageous
- Medical Coding knowledge (ICD10 codes, tariff codes, billing rules set out by SAMA)
- Understanding of billing rules and interpretation of coding set out by SAMA
- Knowledge on PMBs is essential
NOTE: Please apply online. Due to large volumes, we are unable to consider direct applications via Whatsapp or email. The final remuneration package offered by the employer will be determined based on market standards, considering the candidate's qualifications, skills, and level of experience. The employer retains the prerogative to provide a remuneration package that aligns with industry norms and the specific attributes of the selected candidate. 
