Description

Medical Billing & Claims Reconciliation Administrator

A busy specialist medical practice is seeking a highly organized and detail-oriented Medical Billing & Claims Reconciliation Administrator to join our team.

The successful candidate will be responsible for overseeing the full medical aid claims reconciliation process, ensuring accurate tracking of submissions, payments, rejections, outstanding balances, and debtor follow-up.

This role is critical to maintaining the financial integrity and operational efficiency of the practice.

Key Responsibilities:

• Daily reconciliation of medical aid remittance advice and pay runs

• Monitoring submitted claims and tracking payment status

• Identifying and resolving unpaid, partially paid, or rejected claims

• Following up with medical aids regarding outstanding accounts and claim queries

• Patient billing and management of co-payments/outstanding balances

• Maintaining accurate debtor and aging reports

• Ensuring claims are submitted accurately and timeously

• Assisting with revenue tracking and financial reporting

• Liaising with practice management regarding unresolved billing issues

• General medical administration support where required

Requirements:

• Previous experience in medical billing and claims reconciliation essential

• Knowledge of South African medical aid schemes and billing workflows

• Experience with medical practice management software advantageous

• Strong numerical accuracy and attention to detail

• Ability to work independently and manage large claim volumes

• Excellent organizational and communication skills

• Strong follow-through and problem-solving ability

Advantageous:

• Experience in radiology/specialist practice billing

• Understanding of ICD-10 and procedure coding

• Experience handling remittance advice and debtor management

Please send your resume/CV