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