Legal Claims Department; regarding the processing of High Risk claims. To quickly resolve claims. Providing high risk/overdue claims of other's portfolio where required. To manage a high-risk claims portfolio To ensure resolution of claims Assist clients with queries/complaints where necessary Work every aspect of a claim with years' experience in handling Legal Cost Insurance Claims Portfolio. Special Requirements Must be available centric focus; High EQ; Perfect knowledge of the claims procedure manual; History of consistent high performance
Together with our client, a leading claims administrator in Johannesburg North, we are recruiting for Controller to assist with Private and medical aid claims. Implement credit control procedures for specialist outstanding claims. Apply any necessary fixes or adjustments to claims. Monitor and follow up on claims related rejections from medical aids and upfront claim rejections Submit paper claims when electronic submission is not
variances. Revenue/Debtors Check all medical aid claims are loaded on Health Bridge and correctly submitted Medical Aid in respect of submitted claims and confirm status of claims. Follow-ups on payments due from Reconciliation of unmatched items on Health Bridge Claim reversal confirmations, approvals, and allocations allocations. Compile weekly report for each clinic on claim status. Weekly follow-up on medical aid outstanding
variances. Revenue/Debtors Check all medical aid claims are loaded on Health Bridge and correctly submitted Medical Aid in respect of submitted claims and confirm status of claims. Follow-ups on payments due from Reconciliation of unmatched items on Health Bridge Claim reversal confirmations, approvals, and allocations allocations. Compile weekly report for each clinic on claim status. Weekly follow-up on medical aid outstanding
service providers with details of progress on payment claims and services. Help resolve queries from internal Reconciliation Administration Reconciliations on claim matters that are requested and not yet paid. Reconciliation Reconciliation of bank attachment transactions to the claims management system. Tracking and recording of outstanding Validation of claim data in terms of data analysis. Stakeholder Relations Validation of claim data in terms
service providers with details of progress on payment claims and services. Help resolve queries from internal Reconciliation Administration Reconciliations on claim matters that are requested and not yet paid. Reconciliation Reconciliation of bank attachment transactions to the claims management system. Tracking and recording of outstanding Validation of claim data in terms of data analysis. Stakeholder Relations Validation of claim data in terms
technical investigation on Loss Ratio and in-depth claims analysis, corrective actions to be implemented manager with ad hoc requests for underwriting and claims in the Commercial Department. New Business Promoting with complex commercial underwriting matters and claims. Risk Surveys Assisting in communicating and promoting well as brokers and administrators. Claims Assisting the Claims department with Queries on an ad-hoc
technical investigation on Loss Ratio and in-depth claims analysis, corrective actions to be implemented manager with ad hoc requests for underwriting and claims in the Commercial Department. New Business Promoting with complex commercial underwriting matters and claims. Risk Surveys Assisting in communicating and promoting well as brokers and administrators. Claims Assisting the Claims department with Queries on an ad-hoc
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ledger including premium, reinsurance premium, claims, recoveries, commissions and fees. Process reserves client onto the general ledger i.e. outstanding claims, Incurred But Not Reported (“IBNR”), Process income Manage the collection of premiums and settlement of claims Ensure compliance with accounting standards and