Medical Billing Claims Administrator

Medical Billing Claims Administrator

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 and process-driven environment. The successful candidate will have a strong understanding of private specialist billing, medical aid protocols, clinical coding, and claims management.

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.

• 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
• Own reliable transport and a valid driver's licence.
• High attention to detail and data accuracy.
• Ability to work under pressure with minimal supervision.
• Excellent communication and client service skills.

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.

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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.