Processes claims forms on a daily basis as per current ZRV- approved prices for each test and check for completeness of key registration information.
Captures all remittances advices after the amounts have reflected in the bank and attaches proof that it has been captured.
Checks that all claims are processed using the correct tariff and amount to ensure successful claims submission.
Checks if claims registered using the correct currency and perform reconciliation for system variances arising from exchange rate gains or loses
Generates proforma invoices for patients for pre authorisation of tests from the medical aid
Follows up on outstanding claims from funders and other clients
Checks that all remittances received were captured by reconciling total billing and the actual remittances.
Reconciles total billing report vs. NH263 to check if what was billed was claimed in full
Investigates outstanding accounts and group them as either member of funder liable to advise queries list on who to follow up for settling the outstanding bill.
Prepares a queries list report for unpaid balances and submit these to the Finance Manager and the Administration Manager weekly.