Function Other Facility Position Claim Submission Specialist x9 Introduction

Vacancies exist for Nine Claim Submission Specialist based at the Cape Town Regional Office, reporting to the Team Lead – Claim Submission Specialist. The successful candidate will manage the initial stages of the claims process as well as any rejections. The job exists to ensure that claims are accurately submitted and processed, facilitating timely and fair settlements.

Critical Outputs

Ensuring the appropriate optimisation of revenue

Accurate billing and funder contract interpretation:

Ensure accurate and complete coding of patient accounts was done by the Case Manager.

Ensure the correct application and correct interpretation of funder contracts.

Ensure the correct application and correct interpretation of funder FFS claims.

Report on alerts RSRT risks identified to manager.

Identify and monitor gaps a...