Medical Aid Claims Administrator

Patients meet you first at this dental practice in Pretoria West, so calm and clear matters. Someone who likes a bit of variety, but also likes doing things the right way, will enjoy this.

Home base is a dental practice on the Pretoria West side of Gauteng. The first two weeks are spent shadowing someone experienced.

• Check medical aid membership and benefits before each consultation
• Code consultations and procedures with ICD-10 and CCSA or NHRPL tariffs
• Keep patient records locked and share them only with written consent
• Submit claims electronically and work through the rejection report daily
• Request pre-authorisation for scans, procedures and admissions
• Take payments, issue receipts and balance the cash-up at close
• Answer the phones and send clinical questions to the right nurse or doctor

• Matric
• You keep patient information private, every time
• Experience on a practice system such as GoodX, Elixir, Medinol or Healthbridge
• At least 2 years in a medical practice, hospital or billing bureau
• Sound knowledge of ICD-10 coding and medical aid tariff codes
• Confident with Excel and email

• Experience with hospital case management and pre-auth
• Understanding of how HPCSA practitioner and BHF practice numbers are used on claims
• Medical terminology or clinical coding certificate

• Bonus linked to collections at billing bureaus
• Normal practice hours with most weekends off
• Parking on site

• Name the billing software you know in your CV headline; practices want someone who needs no system training.
• Give numbers if you can, such as your rejection rate or how much you cut the 90-day debtors.