Medical Billing Claims Administrator

Location: Pretoria East, Gauteng

Position Type: Permanent | Full-Time

Salary: Market-Related (Based on Experience)

Industry: Medical Billing | Healthcare Administration | Specialist Medical Billing

About the Opportunity

Medical Resources Group is recruiting on behalf of our client, a well-established Medical Bureau based in Pretoria East, for an experienced and detail-oriented Medical Billing Claims Administrator.

This opportunity is ideally suited to a candidate with recent, hands-on experience in specialist medical billing, who thrives in a fast-paced and process-driven environment. The successful candidate will have a strong understanding of private specialist billing, medical aid protocols, clinical coding, and claims management.

Key Responsibilities

Specialist Billing & Claims Administration

• Manage the full billing cycle for specialist medical clients.

• Submit medical aid claims and manage claim rejections and queries.

• Ensure accurate application of ICD-10, CPT, and procedure codes.

• Process PMB claims and apply relevant modifiers correctly.

• Maintain accurate and up-to-date billing records and patient information.

• Support month-end billing processes and account reconciliations.

Medical Aid & Client Liaison

• Liaise professionally with medical practices, patients, and medical schemes.

• Follow up on outstanding claims, rejections, and account queries.

• Ensure excellent client service and communication at all times.

• Maintain confidentiality and compliance with patient information regulations.

Administration & Reporting

• Ensure data integrity and accuracy of billing information.

• Maintain electronic filing and documentation systems.

• Assist with administrative functions relating to specialist billing and claims.

• Support internal processes and continuous improvement initiatives.

Minimum Requirements

Essential

• Matric / Grade 12.

• Minimum 2 years' recent medical billing experience within a Medical Bureau or Specialist Medical Practice.

• Direct billing experience for Medical Specialists.

• Strong working knowledge of:

  • ICD-10 coding

  • CPT and procedure coding

  • Medical aid billing procedures and scheme rules

  • PMBs and relevant modifiers

• Computer literate with proficiency in:

  • Microsoft Excel

  • Microsoft Outlook

  • Medical Billing Systems

• Own reliable transport and a valid driver's licence.

• High attention to detail and data accuracy.

• Ability to work under pressure with minimal supervision.

• Excellent communication and client service skills.

Key Competencies

The ideal candidate will be:

• Detail-oriented and highly organised.

• Professional and client-focused.

• Accurate and process-driven.

• Able to manage multiple priorities and deadlines.

• Proactive and solution-driven.

• Able to work independently and as part of a team.

What Our Client Offers

• Competitive monthly salary based on experience.

• 21 days annual leave.

• Annual performance-based bonus.

• Exposure to specialist-focused billing and claims administration.

• Supportive and professional working environment.

• Long-term career growth opportunities.

How to Apply

Please email your CV and supporting documents to:

[email protected]

Subject Line: Medical Billing Claims Administrator – Pretoria East

Please note: Only candidates with direct specialist medical billing experience will be considered.

If you do not receive feedback within 2 weeks, please consider your application unsuccessful.