Medical Claims Administrator Durban

Pillangó Placements • Other • Durban, KwaZulu-Natal, South Africa • $200 - $300 / year • 1d ago

Reference: PTA002871-CB-2

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

Duties & Responsibilities

The 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 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 doctors and patients alike. You will deliver an efficient, consistent, and accurate administrative medical debt service, providing the doctors with monitoring and bureau reports that will allow them to have real-time data on the financial status of the practice. You will become their trusted business partner, ensuring that their cash flow is timely and that their 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 can 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 of PMBs.
Customer service oriented.
Initiative and commitment to achieve.
Attention to detail and quality.
Teamwork oriented.
Excellent communication skills.
Diplomacy.
Presentation skills.
Adaptability.
Analytical thinking.
Continuous learning.

NOTE: We ONLY accept online applications. We do not consider direct applications via WhatsApp or email. SALARY DISCLAIMER: The advertised salary range is merely a guideline to attract a range of potentially suitable candidates for the advertised position. This doesn’t automatically mean that a successful candidate can claim an offer for the maximum advertised salary. It is the prerogative of the future employer to offer a candidate a market-related remuneration package in line with the candidate’s qualifications, skills, and level of experience.