Claims Administrator (6 Month Fixed Term Contract)

Job title : Claims Administrator (6 Month Fixed Term Contract)
Job Location : Gauteng, Roodepoort

Deadline : December 25, 2024

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Job Objectives: To resolve medical aid rejection queries with member where medical aid has no impact e.g. benefit exceeded To resolve medical aid rejection queries with medical scheme e.g. medication authorization To provide member with status update regarding rejection and resolution thereof. To resubmit all rejections within target set per medical aid i.e. between 40 and 60 queries per day to medical aid three days prior to due date of delivery To resolve queries received from patients within a two hour turn-around time e.g. extended supplies due to member going oversees
Knowledge: IT applications areas and delivery channels (Marconi, Phoenix and Exsol) Current IT technology (6 months) Medical Aid Formularies (6 months) Product knowledge (1 year) Pharmacy Council Legislation (1 year)
Minimum requirements Education: Essential National Senior Certificate

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