Medical Claims Validator

A well-established company specialising in the administration of injury on duty claims requires a Medical Claims Validator to assist with the processing and adjudicating of injury on duty medical claims and provide training and feedback to clients.
Manage daily operations of medical invoice processing and adjudication of claim payments to medical service providers;
Build relationships with new and existing clients;
Assist with training and developing staff members, with the aim of continued improvement and optimisation of resources;
Assisting with client support and operational queries on accounts submitted;
Provide medical advice and/or direction on claims to clients;
Following up on outstanding information required from clients and employers for processing of medical claims and invoices;
Provide on-site training and assistance to clients;
Resolve enquiries from clients related to the COID Act and medical treatment of patients;
Contribute to daily operations; and
Endure that all procedures are followed and that all production goals are met.
As a team member add value and contribute to the company:

Assist to accomplish set revenue targets;

Show willingness to adapt to industry and company changes;
Show positive attitude towards your job, colleagues and clients;
Be willing to share knowledge, do training and comply with set company policies; and
Perform ad hoc tasks in line with the objectives of the Company as and when required by the Company.
Job requirements

The candidate must have Matric;
The candidate must ensure that they are familiar with and gain full knowledge of the Compensation for Occupational Injuries and Diseases Act (COIDA);
The candidate must have experience in the Medical Services claims industry and knowledge of legislation regulating the industry;
The candidate must have sufficient medical background to be able to assist with client enquiries and the adjudication of difficult cases where specialist knowledge is required; and
The candidate must gain a full understanding of the processes, procedures and systems used in the execution of the company’s core operations.




Minimum Requirements

Excellent communication (verbal and written), interpersonal and training skills are essential;
Time Management skills and experience;
Drivers licence and own transport;
Computer literate in Microsoft Excel, Word and PowerPoint; and
Ability to adapt and learn new skills.


Beneficial knowledge

COIDA knowledge;
COIDA medical tariff knowledge;
R10k and R14k, depending on the experience and knowledge



Apply Here http://bit.ly/2PpKSek

Job id : , #70071, 35 views,

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