Sunday , September 24 2023

Netcare Driver Vacancies – Product Innovation Claims Assessor

Website Netcare

Job Description:

The Claims Assessor is responsible to ensure accurate application of Business and Benefit Rules when assessing claims

Job Responsibilities:

  • Requires excellent communication skills – verbal and written
  • Identify systems / processes enhancement and implementation
  • Interact with NOH team to assist with issues and data input
  • Keep claims administrator updated with escalations
  • Vendor documentation manage and administer
  • Give feedback to vendors on queries
  • Actively participate as a member of a team to achieve goals
  • Assessing of all claims for all disciplines
  • Ensure professional conduct at all times
  • Management of the Service Level Agreements with medical schemes
  • Work effectively and co-operatively with others to establish and maintain good working relationships that are mutually beneficial.
  • Assist in telephone queries
  • Use system for updates
  • Keep up to date with Netcare’s evolving policies and procedures

Job Requirements:

  • Conversant with ICD 10 and CPT coding
  • Conversant with Scheme Benefits
  • Claim assessing knowledge
  • Accuracy, and Strong numerical ability
  • Conversant with Modifiers and NHRPL

Qualification & Experience:

  • Minimum of 3 years successful claims assessing experience within the Health Care Industry
  • Grade 12 or equivalent NQF level 4 qualification

Job Details:

Company: Netcare

Vacancy Type:  Full Time

Job Location: Sandton, Gauteng, SA

Application Deadline: N/A

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