Medical Claims Administrator - Specialist Billing

About the role

A well-established Medical Bureau in Pretoria East is looking for a Medical Billing Claims Administrator with recent, hands-on experience in specialist billing. The role suits someone who enjoys a fast-paced, detail-oriented environment and understands private specialist claims, medical aid protocols and clinical coding.

Key responsibilities

• Manage full billing cycles for specialist clients
• Submit claims and resolve rejections and queries from medical aids
• Apply ICD-10, CPT and procedure codes accurately
• Handle PMB claims and apply modifiers correctly
• Liaise professionally with clients, practices, patients and schemes
• Maintain up-to-date billing records
• Support reconciliations and month-end processes
• Ensure data accuracy, confidentiality and service excellence

Required profile

• Matric / Grade 12
• At least 2 years of recent medical billing experience in a Medical Bureau or Specialist Practice
• Direct billing experience for Medical Specialists
• Own reliable transport and a valid driver's licence
• High attention to detail, able to work under pressure with minimal supervision
• Strong communication and client service skills

Required skills

• ICD-10, CPT and procedure coding
• Medical scheme rules and billing procedures
• PMBs and relevant modifiers
• MS Excel, Outlook and billing systems

What we offer

• Competitive monthly salary based on experience
• 21 days of annual leave
• Annual performance-based bonus
• Exposure to specialist-focused billing and claims
• Supportive, process-driven work environment

To apply, send your CV by email with the subject line "Medical Billing Claims Administrator - Pretoria East"; only candidates with direct specialist billing experience will be considered.