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    • Claims Administrator (6 Month Fixed Term Contract) at Clicks Group

    Posted: Nov 25, 2024
    Expires: Not specified
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  • To find and apply for jobs at the Clicks Group, visit their official career portal. You can browse current retail, pharmacy, and corporate openings, register your CV online, and track your application status directly through the Clicks Career Site.

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    Claims Administrator (6 Month Fixed Term Contract)

    Job Objectives:

    • To resolve medical aid rejection queries with member where medical aid has no impact e.g. benefit exceeded
    • To resolve medical aid rejection queries with medical scheme e.g. medication authorization
    • To provide member with status update regarding rejection and resolution thereof.
    • To resubmit all rejections within target set per medical aid i.e. between 40 and 60 queries per day to medical aid three days prior to due date of delivery
    • To resolve queries received from patients within a two hour turn-around time e.g. extended supplies due to member going oversees

    Knowledge:

    • IT applications areas and delivery channels (Marconi, Phoenix and Exsol)
    • Current IT technology (6 months)
    • Medical Aid Formularies (6 months)
    • Product knowledge (1 year)
    • Pharmacy Council Legislation (1 year)

    Minimum requirements

    Education:

    Essential

    • National Senior Certificate

    Check how your CV matches this job

    Method of Application

    Interested and qualified? Go to Clicks Group on careers.clicksgroup.co.za to apply

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