Provider Reconciliation Specialist

Duties

• Ensure the provider reconciliations are correctly done daily, weekly and annually
• Ensure quality assurance checks are performed and any discrepancies communicated
• Ensure signed off reconciliations are printed  and reviewed by Team Leader
• Ensure that all disputes from providers are resolved timeously and accurately
• Ensure daily monthly claims overrides are done
• Ensure control checks are in place and audit deliverables are met
• Ensure maintenance of an accurate provider details’ database exists at all times
• Ensure effective customer service to all providers where direct engagement is required

Requisites

• Finance related Diploma/Certificate
• It is imperative that applicants have experience in the field of health insurance
• 2 or 3 years in Finance, Credit Control and Complaints in the health insurance industry and the medical insurance industry. It's essential
• A year or 2 in Health Care Provider Industry (non-clinical) will be advantageous
• Fluency in English and Portuguese is required
• Written and Verbal Communication
• Microsoft Office (especially Excel)
• Ability to meet strict  deadlines
• Problem Solving
• Time management
• Analytical thinking
• Detail orientated

Notes

• Only shortlisted applicants will be contacted
• Send your CV in English and Portuguese