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Pretoria East: Claims Administrator posted by Med Core Billing

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Job Description

The Claims Administrator is responsible for the accurate processing, review, and management of medical claims in compliance with company policies, medical aid rules, and regulatory standards. The role ensures clear and timely communication between clients, healthcare providers, and internal teams while maintaining accuracy, professionalism, confidentiality, and an ethical, efficient work environment.The Claims Administrator also identifies operational inefficiencies, recommends process improvements, and supports continuous improvement initiatives to enhance claims accuracy, turnaround time, and overall service quality.Claims Coding and Billing Accuracy of coding, compliance with billing rules, and adherence to turnaround times.Payment Allocations, Journal Entries, and Credit Notes Accurate allocations, correct application of journal entries/credit notes, and timely record updates.Age Analyses Completion Timely submission, quality debtor follow-up, correct status updates, and accurate records.Telephone Etiquette & Customer Service Professional communication, effective query resolution, positive client feedback.Outlook Management Timely responses and maintenance of an organised inbox.Key Competencies and Job RequirementsEducation & ExperienceMatric (Grade 12) or equivalent qualification required.Minimum 2 years of relevant experience.Other RequirementsOwn reliable transport.Valid drivers license.Working ConditionsOffice-based environment.

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About Other Professions Jobs in Gauteng

Gauteng, the economic hub of South Africa, is home to a diverse range of industries, offering various Other Professions positions for job seekers. Typically, this field encompasses roles such as administrative assistants, human resources specialists, and operations coordinators, among others.

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Generally, salaries in the Gauteng region for Other Professions positions tend to fall within broad ranges. For example, an administrative assistant position may command a salary between R300 000 and R500 000 per annum, depending on experience, company size, and industry sector. However, it is essential to note that actual salaries can vary significantly due to factors such as the specific job requirements, the company’s budget, and the individual’s qualifications.

Common skills required for these roles include proficiency in Microsoft Office applications, excellent communication and interpersonal skills, attention to detail, organisational abilities, and analytical thinking. Typically, candidates with a degree in business administration, human resources, or a related field may be well-suited for these positions.

The financial services sector, technology industry, and manufacturing sector are common industries that employ Other Professions roles. These sectors often require professionals who can provide administrative support, coordinate operations, and manage day-to-day activities. The manufacturing sector, in particular, requires skilled coordinators to oversee production processes, manage inventory, and ensure compliance with quality control standards.

Career development opportunities for individuals in this field are generally good, with many companies investing in employee training and development programs. Typically, career progression paths involve moving into senior administrative roles or transitioning into related fields such as human resources management or business administration. With experience and continuous learning, professionals in this field can expect to move into more senior positions or take on leadership roles within their organisations.


This information provides general career guidance. Actual salaries and requirements vary by employer.



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