Centurion: Tariff and Payment Arrangement Coordinator posted by AllSpes (Pty) Ltd

About the Role

The Centurion: Tariff and Payment Arrangement Coordinator will collaborate closely with Medical Scheme representatives to establish a clear understanding of available Payment Arrangements, maintaining current knowledge of Healthcare related issues, Scheme rules, and regulations. This role involves providing training to MediCharge staff on new Payment Arrangement implementations or changes, as well as sharing co-responsibility for the year-end process.

Key Responsibilities

• Serve as the main point of contact for Payment Arrangement inquiries and communications.
• Build and maintain strong relationships with key Medical Schemes, SpesNet, and relevant parties to facilitate transparent communication channels between VeriClaim and Medical Schemes.
• Stay informed about changes made by Medical Schemes, such as Payment Arrangements, fixed fees, provider-specific agreements, and how fixed fees influence Payment Arrangements.
• Take ownership of new Payment Arrangements or changes to ensure a full investigation is conducted, all information is obtained, and a Change Request is compiled for the changes to be made on VeriClaim.
• Maintain up-to-date knowledge of how Payment Arrangements work on VeriClaim and conduct regular analysis to ensure correct implementation, suggesting improvements to workflow, implementations, and efficiencies.
• Maintain accurate and detailed records of documentation related to Payment Arrangements and regularly update these records.
• Responsible for knowledge sharing to ensure all MediCharge staff know how Payment Arrangements work and are implemented on VeriClaim through training, upskill sessions, and providing guidance.
• Maintain an updated and functional understanding of Scheme increases, Scheme rules, Conversion Factors, Payment Arrangements, VeriClaim Billing Engine, Tariff App, etc.
• Assist with obtaining tariff files and/or general tariff-related queries, Payment Arrangement information, etc.
• Co-responsibility for managing and coordinating all tariff files/Payment Arrangements received throughout the year and during year-end.

Requirements

• Ability to build meaningful relationships.
• Ability to work under pressure and multi-task.
• Analytical thinker.
• Detail-oriented.
• Deadline-focused.
• Excellent interpersonal skills.
• Excellent problem-solving skills.
• Excellent organisational skills.
• Excellent time management skills.
• Excellent conflict management skills.
• Knowledge of the VeriClaim system.
• Highly motivated and enthusiastic.
• Expert knowledge of Excel.
• Self-confidence.
• Customer-focused ability to build customer relations.
• Bilingual (spoken and written language).
• Excellent Communication skills: Written and verbal.

Qualifications

No qualifications mentioned in the original job description.