Claims Intern – Medical (Absa Group)
About the job
Empowering Africa’s tomorrow, together…one story at a time.
With over 100 years of rich history and strongly positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of this exciting growth journey, to reset our future and shape our destiny as a proudly African group.
My Career Development Portal: Wherever you are in your career, we are here for you. Design your future. Discover leading-edge guidance, tools and support to unlock your potential. You are Absa. You are possibility.
Job Summary
To support the Head of Medical Claims in the Medical Department by providing operational support in the Medical Department processes. To process and settle insurance claims in a fast, fair and courteous manner to ensure customer satisfaction, company profitability and good corporate image.
Job Description
Claims vetting and approval (90%)
- Receiving and registering incoming claims.
- Claims adjudication.
- Analyzing all patients’ claims (In terms of completeness and validity) and processing them for payment.
- Examining and confirming member benefits, entitlements and exclusions.
- Preparing member statements (on request) for clients regarding their policy benefit utilization status.
- Preparing payment remittances and credit notes where applicable.
- Liaising with providers on claims queries.
- Prepare management reports.
Customer service, provider negotiations and reconciliation (10%)
- Handling customer queries (walk-in, phone & e-mail) regarding claims and payments
- Assist in reconciliation and attending reconciliation meetings with the providers.
Education
Further Education and Training Certificate (FETC): Financial Sciences (Required)