Medical Billing Claims Administrator

SUMMARY:
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POSITION INFO:
Location: Pretoria East, Gauteng Position Type: Permanent | Full-Time Salary: Market-Related (Based on Experience) Industry: Medical Billing | Healthcare Administration | Specialist Medical Billing About the Opportunity Medical Resources Group is recruiting on behalf of our client, a well-established Medical Bureau based in Pretoria East, for an experienced and detail-oriented Medical Billing Claims Administrator . This opportunity is ideally suited to a candidate with recent, hands-on experience in specialist medical billing who thrives in a fast-paced, process-driven environment. The successful candidate will have a strong understanding of private specialist billing, medical aid protocols, clinical coding, and claims management. Key Responsibilities Specialist Billing & Claims Administration Manage the full billing cycle for specialist medical clients. Submit medical aid claims and manage claim rejections and queries. Ensure accurate application of ICD-10, CPT, and procedure codes. Process PMB claims and apply relevant modifiers correctly. Maintain accurate and up-to-date billing records and patient information. Support month-end billing processes and account reconciliations. Medical Aid & Client Liaison Liaise professionally with medical practices, patients, and medical schemes. Follow up on outstanding claims, rejections, and account queries. Ensure excellent client service and communication at all times. Maintain confidentiality and compliance with patient information regulations. Administration & Reporting Ensure data integrity and accuracy of billing information. Maintain electronic filing and documentation systems. Assist with administrative functions relating to specialist billing and claims. Support internal processes and continuous improvement initiatives. Minimum Requirements Essential Matric \/ Grade 12. Minimum 2 years' recent medical billing experience within a Medical Bureau or Specialist Medical Practice. Direct billing experience for Medical Specialists. Strong working knowledge of: ICD-10 coding CPT and procedure coding Medical aid billing procedures and scheme rules PMBs and relevant modifiers Computer literate with proficiency in: Microsoft Excel Microsoft Outlook Medical Billing Systems Own reliable transport and a valid driver's licence. Close attention to detail and data accuracy. Ability to work under pressure with minimal supervision. Excellent communication and client service skills. Key Competencies The ideal candidate will be: Detail-oriented and highly organised. Professional and client-focused. Accurate and process-driven. Able to manage multiple priorities and deadlines. Proactive and solution-driven. Able to work independently and as part of a team. What Our Client Offers Competitive monthly salary based on experience. 21 days annual leave. Annual performance-based bonus. Exposure to specialist-focused billing and claims administration. Supportive and professional working environment. Long-term career growth opportunities. How to Apply Please email your CV and supporting documents to: 📧 Subject Line: Medical Billing Claims Administrator – Pretoria East Please note: Only candidates with direct specialist medical billing experience will be considered. If you do not receive feedback within 2 weeks , please consider your application unsuccessful.