Medical Claims Processor

Key Responsibilities:

• Manage Healthcare practitioners accounting transactions
• Allocation of payments using medical billing software
• Medical aid & patient follow-ups
• Answering phone calls and calling customers
• Communication with clients, patients, and schemes
• Ensure all account receipting is up to date and accurate
• Investigation of any short payments, rejections
• Management of the entire PMB process and adhering to the PMB policy
• Reporting/communicating any issues in the day-to-day procedures to assigned team leader
• Contribute to daily KPI / operational requirements

To succeed in this role, you should have the following skills and experience:

• Matric with relevant administrative experience
• Accounts background will prove advantageous
• Must have Ophthalmology experience
• Good communication skills – both written and verbal
• A keen eye for detail and desire to probe further into data
• Deadline-orientated and ability to stick to time constraints
• Working knowledge of SAMA / billing codes & rules
• Working knowledge of medical schemes
• Understanding of prescribed minimum benefits (PMB) process
• Experience in the medical industry advantageous
• MS Office (Excel) proficiency – basic/intermediate
• An analytical mind

All interested applicants who possess the qualifying criteria, please send your CV with the following reference number: CP072026 to careers@xpedient.co.za by c.o.b, Wednesday, 29^th July 2026