1 day ago
Job title : Claims Manager – Pet Insurance
Job Location : Gauteng, Johannesburg
Deadline : November 26, 2024
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Duties & Responsibilities:
Authorisation Management:
- Oversee the entire insurance authorisation process for veterinary hospital services, including surgeries, treatments, and diagnostic procedures.
- Overseeing and ensuring all necessary documentation, including medical records, is submitted accurately and in a timely manner.
- Ensuring productivity and execution of authorisations are done timeously.
- Resolve issues with denied claims, claim queries or delayed authorisations.
Administrative Operations:
- Supervise administrative staff responsible for managing patient / client registrations, assessment of claims, and other clerical functions.
- Implement efficient administrative workflows and ensure proper record-keeping.
- Collaborate with clinical departments to ensure smooth coordination between administrative and administrative functions from suppliers.
Financial Oversight:
- Collaborate with the finance department to track and monitor administration and authorisations for payment processing.
- Oversee cost estimates for claims and review concerns related to the product policies for approval of claims.
Team Leadership:
- Lead and develop a team of administrative and authorisation staff, providing training and mentoring as needed.
- Set performance goals for the team and ensure they meet the established standards.
- Conduct performance reviews and provide ongoing feedback for team improvement.
Compliance & Reporting:
- Ensure adherence to all legal, regulatory, and accreditation standards related to veterinary hospital administration claims and pet insurance practices.
- Prepare regular reports on authorisations, denials, and pending claims for senior management.
- Maintain records of all authorizations, including dates, approvals, denials, and appeals.
- Reporting may be required on multiple projects and ensuring delivery on expected timelines / targets set.
Key requirements of the role:
Education:
- Bachelor’s degree in business financial administration (BCom), Business Management Degree / Qualification (NQF5) and or Bachelor of science (BSc) or a related field, would be preferable and advantageous.
- Medical workplace experience working within a veterinary clinic / hospital or medical centre for 2-3 years.
- Qualified Veterinary Nurse would be advantageous and should be very familiar with the veterinary clinic services and practices.
- Additional certifications in pet healthcare management or insurance billing are a plus.
Experience:
- 5+ years of experience in pet healthcare administration, including at least 2 years in an insurance authorisation or billing role.
- Proven experience managing a team within a pet healthcare setting.
- In-depth knowledge of pet health insurance policies, reimbursement processes, and authorization procedures.
- Familiarity with veterinary service, pet hospital administrative processes and insurance claim systems.
- Proficient in office management software and Microsoft Office Suite.
- Strong organizational and leadership skills.
- Excellent communication and interpersonal abilities.
- Ability to multitask and prioritize effectively in a fast-paced environment.
- Problem-solving skills and attention to detail.
- Highly administrative and accurate in execution of tasks.
- Proven experience as an Admin Manager or in a similar role, including motivating of staff and ensuring the team is highly productive.
How to Apply for this Offer
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