Medical Billing Claims Administrator

Qetello Holdings; Pretoria; On-site; ZAR 240,000 - 360,000; Full time

Benefits offered by this job

21 leave days

Annual bonus

Exposure to specialist-focused billing

Process-driven environment

Job summary

Qetello Holdings is seeking a Medical Billing Claims Administrator in Pretoria East to manage specialist billing for private practices and bureaus. You will handle full billing cycles, submit claims, resolve rejections, and ensure accurate ICD-10/CPT coding and PMB modifiers.

The role requires hands-on billing experience, strong communication with clients, and the ability to work under pressure in a fast-paced environment. Competitive benefits accompany a market-aligned salary.

Qualifications

• Matric / Grade 12
• Minimum 2 years of recent medical billing experience in a Medical Bureau or Specialist Practice
• Direct billing experience for Medical Specialists
• Working knowledge of ICD-10, CPT, and procedure coding
• Medical scheme rules and billing procedures
• PMBs and relevant modifiers
• Computer proficiency: MS Excel, Outlook, and billing systems
• Own reliable transport and valid driver’s license
• High attention to detail and data accuracy
• Able to work under pressure with minimal supervision
• Strong communication and client service skills

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

Skills

Medical billing

Specialist billing

ICD-10 coding

CPT coding

PMB rules

Billing systems

Excel

Client service

Education

Matric / Grade 12

Tools

MS Excel

Outlook

Billing software

Job description

Medical Billing Claims Administrator

Location: Pretoria East

Salary: Market-related

Specialisation: Specialist Medical Billing (Private Practice & Bureau)

About the Opportunity

A well-established Medical Bureau based in Pretoria East is looking for a Medical Billing Claims Administrator with recent, hands-on experience in specialist billing. This role is ideal for someone who thrives in a fast-paced, detail-oriented environment and understands the intricacies of 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

Minimum Requirements (All are essential)

• Matric / Grade 12
• Minimum 2 years of recent medical billing experience in a Medical Bureau or Specialist Practice
• Direct billing experience for Medical Specialists
• Working knowledge of:
  • ICD-10, CPT, and procedure coding
  • Medical scheme rules and billing procedures
  • PMBs and relevant modifiers
• Computer proficiency: MS Excel, Outlook, and billing systems
• Own reliable transport and valid driver’s license
• High attention to detail and data accuracy
• Able to work under pressure with minimal supervision
• Strong communication and client service skills

What the Client Offers

• 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