Netcare Driver Vacancies – Product Innovation Claims Assessor

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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