South Africa: Credit Control, Billing & Claims Administrator (Hospital) posted by Greys Recruitment

About the Role

We are seeking an experienced Credit Control, Billing & Claims Administrator to join our client in a hospital setting. The successful candidate will be responsible for ensuring accurate and timely billing, claims administration, and credit control processes. This is an exciting opportunity for a seasoned professional to bring their expertise to a dynamic healthcare organization.

Key Responsibilities

• Capture and verify patient billing information, including ICD-10 codes, tariff codes, and medical aid details
• Submit, track, and follow up on medical scheme and third-party claims
• Investigate and resubmit rejected or short-paid claims
• Manage pre-authorisations, benefit limits, and length-of-stay extensions
• Monitor and manage debtors age analysis (medical aids, patients, third-party payers)
• Follow up on outstanding accounts and manage co-payments and member liability balances
• Reconcile remittance advices and identify underpayments or discrepancies
• Maintain accurate billing, payment, and adjustment records
• Ensure compliance with medical scheme rules and patient confidentiality regulations
• Liaise with case managers, clinicians, finance teams, and scheme administrators

Requirements

• Matric with Mathematics or Accounting
• Diploma or degree in Finance, Accounting, or related field advantageous
• 25 years experience in medical billing, claims administration, and credit control
• Must have experience in a hospital or inpatient healthcare setting
• Working knowledge of ICD-10 coding, medical aid authorisations, and scheme rules
• Experience with medical billing systems (GoodX advantageous)
• Strong attention to detail, organisational skills, and ability to meet deadlines

Qualifications

No formal education/certifications mentioned.

Salary & Benefits

No salary or benefits information provided.