Claims Support Specialist

Main purpose of the Job

To ensure that all Gap claims are accurately captured into the iMed system.

Position Specific Outputs

• Duplicate check claims received, and process claims and emails according to processes.


• Capture all claims received in accordance with relevant legislation and processes.


• Review and process case and non - case related claims in accordance with coding principles, scheme rules and benefits, and managed care policies and processes


• Providing coding review and resolution on call centre queries


• Assess claims edit requests and actioning it in accordance with coding principles, scheme rules and benefits, and managed care policies and processes


• Communicate with Stake holders


• Maintain clinical documents and processes


• Re...