Medical Invoice Controller (Parktown) at Rand Mutual - RMA

Description

THE JOB AT A GLANCE

• As the Medical Invoice Controller, you will be reporting to the Team Leader: Medical Invoice Approval Production. You will manage the medical invoice authorization for payment process efficiently and effectively. This role involves assisting medical invoice processors with technical inquiries, sharing knowledge, educating medical service providers on correct billing practices, and negotiating early settlement discounts on high-value invoices. You will be playing a crucial role in ensuring cost-effective and accurate payments, leveraging your expertise in medical billing and coding, along with strong analytical and customer service skills, to maintain high standards of service and efficiency.

WHAT WILL YOU DO?            

• Manage the authorization for payment processing of medical invoices
• Review and manage medical costs by ensuring no excess tariffs are paid and treatments are appropriate for the injuries sustained
• Review medical documents to make informed invoice assessment decisions
• Handle and review medical accounts where automated payment has failed
• Negotiate and agree on discounts with medical service providers for high-value invoices
• Monitor invoices for over-servicing and identify incorrectly billed invoices, alerting the Medical Invoice Approval Manager and Team Leader as necessary
• Ensure medical creditors are paid within 2 days from the date of receipt.

Requirements

WHAT YOU'LL BRING TO THE TABLE?

• Grade 12 qualification/Matric Certificate
• A degree or national diploma in Nursing or BCMP
• Advantageous: A medical-related qualification or advanced diploma in health sciences is preferred
• Minimum of 3 years’ experience in a related field, such as medical billing, healthcare services, or medical coding
• Proficiency in SAMA, COID, RPL, ICD10 coding, and Nappi Codes
• Strong knowledge of medical terminology.