Medical Billing jobs in Pretoria, Gauteng

Company Description

About Kaelo
Kaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change. Kaelo meets the Healthcare needs of Corporate and Retail clients across South Africa – products offerings include Medical Insurance, Medical Aid, Gap Insurance, Kaelo Money and employee assistance programmes.

Job Description

Role Purpose

To provide accurate, efficient and client-focused operational administration across billing, claims, policy servicing and reporting. The role supports both individual and company clients while contributing to smooth day-to-day operations and continuous system improvement.

Key Responsibilities

• Billing administration: Process billing accurately and within agreed timelines; validate billing information and resolve discrepancies.
• Billing reconciliation: Perform billing reconciliations, investigate and resolve discrepancies, and follow up on outstanding items or client queries.
• Claims administration: Receive, capture, validate and track claims; obtain outstanding documentation and communicate progress through to finalisation.
• Client changes: Action all amendments and instructions received from clients, including member, policy, contact and billing updates, subject to required checks and approvals.
• Client servicing: Provide end-to-end servicing for individual and company clients through professional written and telephonic communication.
• Operational reporting: Compile accurate daily, weekly and monthly reports; monitor volumes, turnaround times, outstanding work and service-level performance.
• System enhancements: Assist with requirements gathering, testing, issue logging, feedback and implementation of operational system improvements.

Administration and controls: Maintain accurate records, follow standard operating procedures, protect confidential information and escalate risks or delays promptly

NB: Only candidates with a RE5 qualification will be shortlisted

Qualifications

Minimum Requirements

• Grade 12; a relevant administration, business or insurance qualification is advantageous.
• 1–2 years’ administration or client service experience; insurance or financial services exposure is advantageous.
• Computer literacy, including Microsoft Outlook, Word and Excel, with confidence using administration systems.
• RE5 is mandatory

Additional Information

Core Competencies

Strong attention to detail; accuracy; organisation and prioritisation; customer focus; clear communication; problem-solving; teamwork; accountability; adaptability; and the ability to work under pressure and meet deadlines.

Personal Attributes

• Accountability
• Action orientated
• Collaborative
• Communication
• Business writing skills
• Manage complexity
• Problem solving skills
• Decision thinking
• Encourages engagement
• Resilient and adaptive
• Resourceful
• Demonstrates self-awareness
• Purpose driven
• Significance and values orientated