Credit Controller – Medical Aid Collections & Patient Claims

Location: Centurion

Position: Full-time

Start Date: Immediate

Job Description

We are seeking a detail-oriented and proactive Credit Controller to manage the collection of outstanding medical aid claims and patient balances. The successful candidate will be responsible for following up on unpaid medical aid claims, liaising with medical schemes, and ensuring prompt payments from patients and insurers. This role requires strong communication skills, knowledge of medical billing processes, and the ability to resolve claim discrepancies effectively.

Responsibilities

• Medical Aid Claims Follow-Up: Track and follow up on submitted claims to ensure timely processing and payment by medical aid schemes.
• Claim Rejections & Resubmissions: Identify rejected or unpaid claims, investigate reasons for non-payment, and facilitate corrections or resubmissions.
• Patient Debt Collection: Contact patients regarding outstanding balances due to shortfalls, co-payments, or unpaid medical aid claims.
• Payment Negotiations: Work with patients to set up payment arrangements while maintaining professionalism and empathy.
• Account Reconciliation: Ensure accurate recording of payments, outstanding balances, and any claim adjustments.
• Dispute Resolution: Address disputes with medical aids and patients regarding unpaid claims, benefits, and policy coverage.
• Reporting & Record Keeping: Maintain up-to-date records of outstanding claims, payment statuses, and follow-up actions.
• Regulatory Compliance: Ensure adherence to medical aid regulations, patient confidentiality (POPI Act), and practice policies.

Required Skills & Qualifications

• Experience: 1 year in credit control, medical billing, or debt collection within a healthcare environment.
• Knowledge: Strong understanding of medical aid claims processing, ICD-10 codes, PMB conditions, and healthcare billing.
• Communication Skills: Excellent verbal and written communication skills for liaising with medical aids and patients.
• Problem-solving: Ability to resolve claim rejections, payment disputes, and outstanding balances efficiently.
• Attention to Detail: Strong analytical skills to identify and correct claim errors.
• Tech Savvy: Proficiency in medical billing software, Microsoft Excel, and Outlook.
• Regulatory Awareness: Familiarity with medical aid regulations and the POPI Act.

Preferred Qualifications

• Background in a medical practice, hospital, or healthcare debt collection environment.
• Certification in credit management, medical billing, or a related field is advantageous but not required.

How to Apply
If you have the required experience and skills, please submit your CV and a cover letter to neil@sims.co.za. If you haven’t heard from us within 14 days, consider your application unsuccessful.

Medical Billing Administrator – Full-Time (Remote)

Location: Remote

Position: Full-time Medical Billing Administrator

Start Date: Immediate

Job Description

We are currently seeking a motivated and detail-oriented Medical Billing Administrator to join our team. In this role, you will be responsible for managing the billing processes for our healthcare clients, ensuring accuracy, compliance, and timely submission of claims.

Responsibilities

• Process and submit medical claims to medical aids.
• Review and verify patient information, medical aid details, and treatment codes.
• Follow up with medical aids and patients on outstanding claims and denials.
• Maintain accurate billing records and track payment status.
• Communicate with clients and medical aids regarding billing enquiries.
• Stay up to date with changes in billing codes, medical aid policies, and healthcare regulations.
• Provide regular reports and updates to management.

Qualifications

• Proven experience in medical billing and coding (minimum of 2 years preferred).
• Knowledge of medical terminology, ICD-10, CPT, and HCPCS coding.
• Attention to detail and strong organisational skills.
• Ability to work independently and manage time effectively.
• Proficiency in using medical billing software e.g. GoodX or MEDEDI.
• Strong communication skills.

How to Apply
To apply, please send your CV and a cover letter detailing your experience to neil@sims.co.za. If you haven’t heard from us within 14 days, consider your application unsuccessful.