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  • Posted: Nov 25, 2024
    Deadline: Not specified
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  • Clicks Group is a retail-led healthcare group which has been listed on the JSE Limited since 1996. Through market-leading retail brands Clicks, GNC, The Body Shop and Claire's, the group has over 840 stores across southern Africa. Clicks Group is a leader in the healthcare market where Clicks has the largest retail pharmacy chain with over 620 in-store pharm...
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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 aligns with this job

    Method of Application

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

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