Product Innovation Claims Assessor - Durban, South Africa - Aloecrest Medical Hospital

Aloecrest Medical Hospital
Aloecrest Medical Hospital
Verified Company
Durban, South Africa

1 week ago

Thabo Mthembu

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Thabo Mthembu

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Description

KEY WORK OUTPUT AND ACCOUNTABILITIES

  • Assessing of all claims for all disciplines.
  • Identify systems / processes enhancement and implementation.
  • Management of the Service Level Agreements with medical schemes.
  • Vendor documentation manage and administer.
  • Assist in telephone queries.
  • Give feedback to vendors on queries.
  • Use system for updates.
  • Interact with NOH team to assist with issues and data input.
  • Keep claims administrator updated with escalations.
  • Requires excellent communication skills verbal and written.
  • Actively participate as a member of a team to achieve goals.
  • Keep up to date with Aloecrest's evolving policies and procedures.
  • Active involvement in own professional development to maintain a satisfactory level of skill and knowledge.
  • Ensure professional conduct at all times.
  • Work effectively and cooperatively with others to establish and maintain good working relationships that are mutually beneficial.
  • Create and maintain a positive environment where the differences of others are recognized, understood, and valued, so that all can reach their full potential and maximize their contributions.
  • Develop collaborative relationships to help accomplish work goal.

EDUCATION

  • Grade 12 or equivalent to an NQF at level 4 qualification.

WORK EXPERIENCE

  • Minimum of 3 years successful claims assessing experience within the Health Care Industry

KNOWLEDGE

  • Claim assessing knowledge.
  • Conversant with ICD 10 and CPT coding.
  • Conversant with Modifiers and NHRPL.
  • Conversant with Scheme Benefits.
  • Accuracy, and Strong numerical ability.

Job Types:
Full-time, Permanent


Salary:
R17, R29,000.00 per month


Education:


  • Certificate (preferred)

Experience:

Claims Assessing: 3 years (preferred)


Ability to Relocate:

  • Durban, KwaZulu-Natal: Relocate before starting work (preferred)

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