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