Key Responsibilities The key functions of the role will include but not limited to. To timely register new claim submissions from accredited health care providers. Track claims through the various subsequent workflows. Timely update various claims registers and departmental trackers Perform claims reconciliations both between internal workflow stations as well as with the various health care providers. Attend to audit & claim queries from healthcare providers. Admit all qualifying claims in the claims register immediately on receipt. Maintain good business relationship with Health Care Providers and conduct Health Care Provider sensitisation on NHIMA Benefits, Tariffs, and importance of properly filled in claim forms. Communicate daily to healthcare providers with claims submission omissions. To be able to scan, batch and index claims prior to adjudication. To prepare daily, weekly, claims status reports. To manage the weekly claims adjudication schedule and submission. Participate in any other claims process roles as demand arises and as guided by the Supervisor. Conduct any other roles as assigned by the Supervisor. Education Requirements Grade twelve (12) School certificate with 5 ‘O’ levels with credit or better including Mathematics and English Language (ZAQA Certified). Diploma in a relevant field (ZAQA Certified). Degree in relevant field will be an added advantage (ZAQA Certified). More than six (6) Months relevant work experience in a similar role, Certificate in management of a health insurance scheme, compensation fund or social security will be an advantage Required Skills Excellent knowledge of marketing and customer service, Good oral and written communication skills, Must be computer literate with MS Office applications skills, Attention to detail, and Excellent analytical skills. Sharing is Caring! Click on the Icons Below and Share