Medical Billing Specialist - Bloemfontein

Medical Billing Specialist We are seeking an experienced, adaptable, and tech‑savvy Medical Billing Specialist to join a team of industry experts. In this role, you will manage the full billing lifecycle for various medical disciplines, ensuring fast, accurate, and highly effective claim processing and debt recovery.

Key Responsibilities

Manage end‑to‑end electronic claim submissions (EDI) and real‑time medical aid switching.

Proactively follow up on unpaid claims, investigate rejections, and resolve short payments with medical schemes to minimize revenue leakage.

Perform accurate payment allocations, send patient account statements, and handle billing inquiries.

Execute effective credit control and debt collection strategies, ensuring practice debt older than 60 days is aggressively minimized.

Apply accurate ICD‑10 coding, clinical tariffs, and PMB (Prescribed Minimum Benefits) rules across diverse medical specialties.

Generate and analyze customized financial reports, identifying billing challenges and improving administrative workflows.

Provide ongoing support and maintain excellent communication between the bureau, medical practitioners, and patients.

Minimum Requirements

Experience:

At least 3 years of proven experience in medical billing, claims administration, or working directly within a medical billing bureau environment.

Software Proficiency:

Must have hands‑on, practical experience operating across multiple established medical billing platforms. Extensive knowledge of the following systems is required: Vericlaim, Medimax, MedEDI, GoodX, Elexir, C‑Cloud, Healthbridge, Eminance, MedeMass, Medinol, EZMed.

Industry Knowledge:

Thorough understanding of the South African healthcare funding landscape, medical aid scheme rules, and strict compliance/POPIA requirements.

Attributes:

Exceptional problem‑solving skills, meticulous attention to detail, and a tenacious approach to account management and debt recovery.

Working Hours Monday– Friday from 8:00 – 17:00

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