Medical Benefits Manager at Rand Mutual Holding (Pty) Ltd

🗏Job Type

Full Time

About the Position

Purpose

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.

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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

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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

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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

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Managing Relationships with Medical Service Providers (MSPs):

Maintaining a database of MSPs

Communicating regularly with MSPs to ensure compliance, efficiency etc.

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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

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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 http://bit.ly/2G5KJHC

Job id : , #71393, 8 views,

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