Claims Administrator (6 Month Fixed Term Contract) needed at Clicks Group

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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

How to Apply for this Offer

Interested and Qualified candidates should Click here to Apply Now

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