Claims Administrator

National Risk Managers (Pty) Ltd | Johannesburg, Gauteng | ZA

Welcome to the Latest Job Vacancies Site 2024 and at this time we would like to inform you of the Latest Job Vacancies from the National Risk Managers (Pty) Ltd with the position of Claims Administrator - National Risk Managers (Pty) Ltd which was opened this.

If this job matches your qualifications, please send your application directly through our latest Job site. Indeed, every job is not easy to apply because it must meet several qualifications and requirements that we must meet in accordance with the standard criteria of the Company who are looking for potential candidates to work. Good job information Claims Administrator - National Risk Managers (Pty) Ltd below matches your qualifications. Good Luck: D

Process hospital admission and related accounts received Process hospital admission and related accounts received Receive accounts and authorisation letters ...

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Job Summary
Administer payments of Health claims
Key Responsible Areas
  • Process hospital admission and related accounts received
  • Perform administrative duties
Tasks
Process hospital admission and related accounts received
  • Receive accounts and authorisation letters
  • Opening accounts received
  • Compare ICD10 codes to determine if it’s a condition we cover or an exclusion
  • Process day to day claims
  • Perform administrative duties
  • Capture notes into the relevant folders and claims management system
  • Advise the Providers/ Members when maximum benefits have been paid
  • Request decline letters for conditions/ accounts not covered
  • Engage with Members/ Providers regarding their queries
  • Contact Members when they are unsure about their cover, benefit limits, declines or payment allocations and provide them with detailed statements or reports
  • Provide Members, Agents or Service Providers with feedback with regards to the claim progress
  • Check hospital claims for correctness (completed in full)
  • Send proof of payments to Members/ Service providers
  • File POP’s and accounts
  • Send out daily statistics
  • Obtain all the relevant documentation required for the applicable benefit
Perform administrative duties
  • File all relevant emails
  • Capture claims on the claims management system
  • Reconcile account received and send to the financial administrator for payments to be loaded
  • Compile and submit periodic reports
Essential Qualifications
  • Matric



Essential Experience
  • Minimum 2 years in the insurance industry and its products.



Knowledge and Skills
  • Excellent administrative skills
  • Knowledge of medical claims handling
  • Knowledge of and adherence to the Policies and Procedures relating to hospital claims
  • Knowledge of medical operating systems
  • Excellent computer skills (MS Office, Excel)
  • Excellent written and communication skills
  • Time management skills
  • Excellent interpersonal skills
  • Client relationship-building skills
Attributes
  • Patience (to deal with difficult Members)
  • Positive attitude
  • Ability to multi-task
  • Professional demeanor and appearance
  • Team player/ work independently
  • High level of enthusiasm
  • Innovative/ energetic
  • Ability to work under pressure
  • High degree of commitment
  • Motivated
  • Accuracy
  • Deadline orientated
  • Honest, hardworking and humble
For more information please contact: Nirusha Sampat

Information :

  • Company : National Risk Managers (Pty) Ltd
  • Position : Claims Administrator
  • Location : Johannesburg, Gauteng
  • Country : ZA

How to Submit an Application:

After reading and knowing the criteria and minimum requirements for qualifications that have been explained from the Claims Administrator job info - National Risk Managers (Pty) Ltd Johannesburg, Gauteng above, thus jobseekers who feel they have not met the requirements including education, age, etc. and really feel interested in the latest job vacancies Claims Administrator job info - National Risk Managers (Pty) Ltd Johannesburg, Gauteng in 18-02-2024 above, should as soon as possible complete and compile a job application file such as a job application letter, CV or curriculum vitae, FC diploma and transcripts and other supplements as described above, in order to register and take part in the admission selection for new employees in the company referred to, sent via the Next Page link below.

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Post Date : 18-02-2024

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