Specialist Medical Billing & Claims Administrator

Medical Resources Group (Pty) Ltd; Pretoria; On-site; ZAR 180,000 - 240,000; Full time

Benefits offered by this job

21 days annual leave

Annual performance-based bonus

Exposure to specialist-focused billing

Process-driven work environment

Job summary

Medical Resources Group (Pty) Ltd, based in Pretoria East, is seeking a Medical Billing Claims Administrator with hands-on specialist billing experience. You will manage billing cycles for specialist clients, submit claims, and resolve medical aid queries in a fast-paced environment.

Requirements include 2+ years in medical billing, ICD-10/CPT coding, PMBs knowledge, and proficiency with billing systems. The role offers a competitive salary, 21 days leave, and a performance-based bonus.

Qualifications

• Minimum 2 years of recent medical billing experience in a Medical Bureau or Specialist Practice.
• Direct billing experience for Medical Specialists.
• Strong understanding of ICD-10, CPT, and procedure coding.
• Knowledge of medical scheme rules and billing procedures.
• Experience with PMBs and relevant modifiers.
• Proficiency with MS Excel and billing software.

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

ICD-10 coding

CPT coding

PMBs & modifiers

Client communication

Data accuracy

MS Excel

MS Outlook

Education

Grade 12 / Matric

Tools

Billing systems

MS Excel

Outlook

Job description

Medical Resources Group (Pty) Ltd, based in Pretoria East, is seeking a Medical Billing Claims Administrator with hands-on specialist billing experience. You will manage billing cycles for specialist clients, submit claims, and resolve medical aid queries in a fast-paced environment.

Requirements include 2+ years in medical billing, ICD-10/CPT coding, PMBs knowledge, and proficiency with billing systems. The role offers a competitive salary, 21 days leave, and a performance-based bonus.