Healthcare Bureau: Claims Administrator

An exciting opportunity exists for a Bureau Claims Administrator in Umhlanga with a Healthcare IT company.

 

The successful Candidate, who will report to the Bureau Manager, will be responsible for delivering an efficient , consistent and accurate administrative medical claiming service to the Company's clients.  You will also be required to provide Healthcare Practices with monitoring and reports thereby allowing access to real time data on the financial status of each practice. You will become Practice's trusted business partner ensuring that cash flow is timous and aged debt is at a minimum.

Roles and Responsibilities:
● Ensure that all claims are accurately captured before they are submitted electronically to medical schemes
● Promptly respond to claim rejections

● Allocate and reconcile remittance advices
● When capturing patient data, select correct scheme agreement options, so that patient's are billed at the correct rates
● Follow-up on all claims with outstanding balances
● Correct claims with errors and resubmit for payment
● Maintain a low age analysis 
● 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 patient
● Build and maintain relationships with clients
● Monitor and maintain doctors databases with the assistance of BI reporting

Job Requirements

Qualifications & Experience:
● Matric and relevant administrative qualification
● Google-Suite Experience is advantageous
● 2-3 years Industry knowledge
● Must have knowledge on PMBs

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Knowledge and Skills:

Technical Skills:
● Professional Knowledge
● Computer Literacy
● Numerical ability
● Financial Awareness

Customer Focus:
● Customer Service and Orientation
● Initiative and Commitment to Achieve
● Attention to Detail and Quality

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Teamwork:
● Team Orientation
● Excellent Communication Skills
● Diplomacy

Competences:
● Personal Impact
● Presentation Skills
● Organizational Awareness
● Adaptability
● Continual Improvement
● Analytical Thinking
● Continuous Learning​

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Apply if you have the Qualifications, Skills and Experience and this Oppotunity is for you !