Medical Benefits Manager at Rand Mutual Holding (Pty) Ltd

Job Status: Active ✓

Safety Tips For Candidates

✓ Check if the Job is Still Active
✓ Check the start date
✓ Never Pay for a Job
✓ Always Report Scams to us
✓ Meet Employer in a professional location

View all ads from Jobking Jobs (8060)

Job TypeFull Time

About the Position


Reporting to the Medical General Manager, the incumbent will ensure that customers receive effective treatment by establishing a robust network of providers that deliver optimal medical service and ensuring that they are paid timeously for their services.



Qualifications and Experience Required

Administration qualification (Diploma/Degree)

Medical Diploma/Degree (such as Nursing) advantageous

Medical experience (e.g. Nursing) advantageous

Medical claims and invoice processing experience required

At least 5 years of Management experience

Customer Relationship Management experience

COIDA knowledge required

Insurance and/or Medical Aid experience

Knowledge of invoice processing, claims management

Understanding of all MSP Tariffs (COID, SAMA etc.)

Knowledge of business policies, processes and procedures, legal compliance



Key Areas of Responsibility

Managing the Medical Benefits Department:

Managing Medical Benefits Team Leaders and their Controllers and Processors

Reviewing daily/weekly/monthly invoice payments

Tracking performance based on business requirements (including budgets)

Cost saving initiatives

Ensure clean Departmental audits


Medical Invoice Processing:

Reviewing trends, variances and making changes to improve performance

Ensuring that systems are used effectively to improve accuracy and minimise errors

Participation in Satisfaction survey


Managing Relationships with Medical Service Providers (MSPs):

Maintaining a database of MSPs

Communicating regularly with MSPs to ensure compliance, efficiency etc.


Reporting on Progress:

Using appropriate templates and channels to report progress on a weekly and monthly basis

Adhering to deadlines and ensuring accuracy and quality


Knowledge, Skills and Competencies required

Business Skills

Customer Focus

Negotiation and Persuasive Skills

Networking Ability (Internal and External)

Numerical Ability

Process and System Competence

Relationship Building (Internal and External)

Verbal Communication

Apply Here

Job id : , #71393, 7 views,