CLAIMS CONTROLLER – JOBS NAMIBIA

Introduction
The primary purpose of this position is the clinical auditing of manual claims and daily audit trail reports. Reporting to the Team Leader: PSEMAS Claims.

Role Purpose
The primary purpose of this position is the clinical auditing of manual claims and daily audit trail reports. Reporting to the Team Leader: PSEMAS Claims.

Requirements
Grade 12 with 25 IGCSE points (Strong Requirement), or a Business related qualification.

3 Years experience as a medical aid claims assessor and/or
3 Years administrative experience in a medical practice
Working knowledge of various medical service providers’ claims assessing as well as
Working knowledge of the EDI/RTS claims assessing would be an added advantage
Experience in the medical industry will serve as an added advantage

Duties & Responsibilities
Audits the daily Audit Trail Reports on claims assessment
Responsible for reversing and correcting of claims that have gone through the pay-run process
Attends to the claims enquiries and or reversals sent via Tracking Enquiries on system and
hoc tasks that may arise

Competencies
Proficient with Microsoft products (Word, Excel, Outlook)
Excellent interpersonal skills and portray good self-image
High levels of personal ethics, integrity and emotional maturity
Good knowledge of networking and reporting
Able to work well under pressure and independently
Strong analytical and problem solving skills.