IOD Validator

Together with our client who is a leader in IOD claims administration, we are recruiting for a Senior IOD/WCA Claims Validator to assist with the processing and adjudicating of statutory claims. 

Duties and Responsibilities

• Assess COID claim information
• Assess billing on account per item in terms of COID Gazette
• Assess accounts against payment history received from COID
• Practice management of assigned practices
• Effective communication with assigned practices
• Assisting with client support and operational queries on accounts submitted;
• Provide medical advice and/or direction on claims to clients;
• Following up on outstanding information required from clients and employers for processing of medical claims and invoices;
• Resolve enquiries from clients related to the COID Act and medical treatment of patients;
• Contribute to daily operations; and
• Endure that all procedures are followed and that all production goals are met.

As a team member add value and contribute to the company:

• Assist to accomplish set revenue targets;
• Show willingness to adapt to industry and company changes;
• Show positive attitude towards your job, colleagues and clients;
• Be willing to share knowledge, do training and comply with set company policies; and
• Perform ad hoc tasks in line with the objectives of the Company as and when required by the Company.

Requirements

• The candidate must have Matric;
• The candidate must ensure that they are familiar with and gain full knowledge of the Compensation for Occupational Injuries and Diseases Act (COIDA);
• The candidate must have experience in the Medical Services claims industry and knowledge of legislation regulating the industry;
• The candidate must have sufficient medical background to be able to assist with client enquiries and the adjudication of difficult cases where specialist knowledge is required; and
• The candidate must gain a full understanding of the processes, procedures and systems used in the execution of the company’s core operations.
• Excellent communication (verbal and written), interpersonal and training skills are essential;
• Time Management skills and experience;
• Drivers licence and own transport;
• Computer literate in Microsoft Excel, Word and PowerPoint; and
• Ability to adapt and learn new skills.

Salary:

• Market Related   

If you meet the above requirements, please send your cv to recruit@medicalresources.co.za with REF: Validator