Claims Support Specialist

fulltime Other Office and Administrative Support Workers

Main purpose of the Job

To ensure that all Gap claims are accurately captured into the iMed system.

Position Specific Outputs

 

• Duplicate check claims received, and process claims and emails according to processes.


• Capture all claims received in accordance with relevant legislation and processes.


• Review and process case and non - case related claims in accordance with coding principles, scheme rules and benefits, and managed care policies and processes


• Providing coding review and resolution on call centre queries


• Assess claims edit requests and actioning it in accordance with coding principles, scheme rules and benefits, and managed care policies and processes


• Communicate with Stake holders


• Maintain clinical documents and processes


• Re...