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Absa Bank Limited (Absa) is a well-established financial institution offering a wide range of banking and insurance services. Committed to customer satisfaction and operational efficiency, Absa is seeking a detail-oriented and skilled Medical Claims Officer to provide crucial support within their medical claims processing unit.
Absa Bank Limited is looking for a dedicated Medical Claims Officer to support the Medical Claims Manager in the efficient and accurate processing of medical insurance claims.
Medical Claims Officer - Absa Bank Limited
Job Overview
Positions Available: 1
Employment Type: Full Time
Deadline: 2nd May 2025
Salary: Not Specified
Job Summary
The Medical Claims Officer will be responsible for providing operational support in the medical claims processes, ensuring the timely, fair, and courteous settlement of insurance claims to enhance customer satisfaction, company profitability, and maintain a positive corporate image.
Job Description
Claims Vetting and Approval:
- Receiving and registering incoming medical claims.
- Performing claims adjudication.
- Analysing patient claims for completeness and validity and processing them for payment.
- Examining and confirming member benefits, entitlements, and exclusions.
- Preparing member statements (upon request) regarding policy benefit utilization.
- Preparing payment remittances and credit notes where applicable.
- Liaising with healthcare providers on claims queries.
- Preparing management reports related to medical claims.
Customer Service, Provider Negotiations, and Reconciliation:
- Handling customer inquiries (walk-in, phone, and email) regarding medical claims and payments.
- Assisting in the reconciliation process and attending reconciliation meetings with healthcare providers.
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Education and Experience Required
- Bachelor’s degree in actuarial science or Diploma in pharmacy, clinical medicine, nursing, laboratory technology, or any other medical-related course.
- Certificate of Proficiency in Insurance (COP) & Associate of the Chartered Insurance Institute (ACII) will be an added advantage.
- At least one year of experience in a busy insurance-related field.
- Strong analytical skills are required.
Method of Application
Interested and qualified candidates should apply through the Absa Bank Limited career portal:
📌 Note: Only shortlisted candidates will be contacted.