Bloemfontein: Billing Specialist – Bloemfontein posted by Aspire Recruiting

About Our Client

We are partnering with a leading, highly reputable medical practice management and billing solutions bureau. Our client specializes in providing integrated financial and administrative solutions to medical professionals, handling everything from electronic claim submissions and account management to dedicated credit control and debt collection. Their mission is to optimize practice profitability and cash flow, allowing healthcare providers to focus entirely on patient care.

The Role

We are seeking an experienced, adaptable, and tech-savvy Medical Billing Specialist to join a team of industry experts. In this role, you will be responsible for managing the full billing lifecycle for various medical disciplines. You will utilize your deep knowledge of multiple practice management systems to ensure fast, accurate, and highly effective claim processing and debt recovery.

Key Responsibilities

• Manage end-to-end electronic claim submissions (EDI) and real-time medical aid switching.

• Proactively follow up on unpaid claims, investigate rejections, and resolve short payments with medical schemes to minimize revenue leakage.

• Perform accurate payment allocations, send patient account statements, and handle billing inquiries.

• Execute effective credit control and debt collection strategies, ensuring practice debt older than 60 days is aggressively minimized.

• Apply accurate ICD-10 coding, clinical tariffs, and PMB (Prescribed Minimum Benefits) rules across diverse medical specialties.

• Generate and analyze customized financial reports, identifying billing challenges and improving administrative workflows.

• Provide ongoing support and maintain excellent communication between the bureau, medical practitioners, and patients.

Minimum Requirements

• Experience: At least 3 years of proven experience in medical billing, claims administration, or working directly within a medical billing bureau environment.

• Software Proficiency: Must have hands-on, practical experience operating across multiple established medical billing platforms. Extensive knowledge of the following systems is required:

  • Vericlaim, Medimax, MedEDI, GoodX, Elexir, C-Loud, Healthbridge, Eminance, MedeMass, Medinol, EZMed

• Industry Knowledge: Thorough understanding of the South African healthcare funding landscape, medical aid scheme rules, and strict compliance/POPIA requirements.

• Attributes: Exceptional problem-solving skills, meticulous attention to detail, and a tenacious approach to account management and debt recovery.

How to Apply If you have the technical system knowledge and the billing expertise to drive practice profitability, we want to hear from you. Please submit your updated CVexplicitly detailing the medical billing software systems you are proficient in.