We are seeking a diligent and detail-oriented Claims Clerk to join our Billing department. The ideal candidate will be responsible for processing claims, verifying patient information, and ensuring timely reimbursement from insurance providers. This role is crucial in maintaining the financial health of our hospital while providing excellent service to our patients.
Duties and Responsibilities
• Completes claim forms ensuring that all sections have been correctly filled. • Checks accuracy and completeness of claim forms. • Timely submission of claim forms to medical aids. • Transfers patient balances to medical aid accounts or corporate accounts in the system. • Attends to medical aid queries on claims. • Correct and re-submit claims for rejected claims. • Updates and circulates claims daily , weekly and monthly reports . • Ensures that all medical aid patients have been authorized on admission. • Ensures that completed claims conform to AHFoZ standards or other regulations as stipulated. • Maintaining accurate financial records and ensuring timely and accurate billing to clients • Overseeing of all hospital claims and making payment follow ups with medical aids on payments .
Ad
Qualifications and Experience
1. Certificate in Claims and Benefits Processing/ Accounting or equivalent. 2. 1 year experience in a similar role within the health sector. 3. Experience with Health 263 is a must. 4. Strong knowledge of health insurance policies and medical billing codes 5. Attention to detail. 6. Good communication and personality skills. 7. Knowledge of computer applications such as word processing, spreadsheets and financial software.
How to Apply
The application should be submitted to: humanresources@smc24.co.zw ,with the following email subject line “Claims Clerk Application”.
