93 Claims Handling jobs in South Africa
Billing & Medical Claims Processor
Posted today
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Job Description
Job Title:
Billing & Medical Claims Processor
Schedule:
Monday – Friday | 8:00 a.m. – 5:00 p.m. PST
(5:00 p.m. – 2:00 a.m. South Africa Standard Time)
Location:
Remote – Based in South Africa
Reports To:
Director of Accounting & Finance
About the Opportunity
Total Care Connections—one of the largest home care providers in Arizona and Colorado—is seeking a detail-oriented and experienced
Billing & Medical Claims Processor
to join our growing team.
This full-time remote role is based in South Africa but aligned with U.S. Pacific Standard Time hours. The ideal candidate has strong English communication skills, experience in U.S. medical billing and claims management, and a proven ability to work in a fast-paced healthcare environment.
About the Role
As a Billing & Medical Claims Processor, you will be responsible for the
end-to-end revenue cycle process
, including billing, claims submission, adjudication, payment posting, collections, and accounts receivable management. You will ensure accuracy, compliance, and timeliness in all financial transactions, while serving as a key support to the Director of Accounting & Finance.
This role is critical to ensuring that Total Care Connections maintains healthy cash flow and compliance across all payer types.
Key Responsibilities
Billing & Claims Management
- Prepare, review, and submit accurate claims through
Office Ally
and
Waystar
for private insurance, Medicaid, Medicare, VA, long-term care insurance, and private pay clients. - Verify insurance eligibility and benefits prior to billing.
- Ensure all claims meet payer-specific requirements, HIPAA regulations, and industry coding standards.
- Track, manage, and resolve claim rejections and denials; submit corrections and appeals as needed.
- Maintain claim status logs and follow up with payers to ensure timely adjudication.
Accounts Receivable & Collections
- Post payments (EFT, ACH, credit card, checks) accurately and reconcile against remittance advice (ERA/EOB).
- Manage client invoicing, account statements, and collections activities, including outbound calls for past-due accounts.
- Monitor aging reports and escalate overdue balances.
- Process refunds, adjustments, and write-offs in accordance with company policy.
- Maintain accurate A/R records for monthly reporting.
Revenue Cycle Operations
- Perform daily reconciliation of deposits and payment postings.
- Conduct audits of claims and payments to identify errors, trends, or compliance risks.
- Support prior authorization requests and documentation when required.
- Collaborate with schedulers, nurses, and caregivers to resolve billing discrepancies tied to services rendered.
- Assist with monthly close by preparing A/R and collections reports.
Compliance & Process Improvement
- Stay current with Medicare, Medicaid, and private payer billing regulations.
- Ensure strict adherence to HIPAA and internal confidentiality requirements.
- Identify opportunities to improve billing efficiency and accuracy.
- Support internal and external audits related to billing and claims.
Qualifications
- Bachelor's degree preferred (Accounting, Finance, Healthcare Administration, or related field).
- Minimum 2–3 years of experience in U.S. medical billing and claims processing, preferably in home health or healthcare.
- Proficiency with
Office Ally, Waystar, ERA/EOB posting, and payment systems (ACH, credit card processing). - Strong knowledge of medical claims adjudication, payer rules, and denial management.
- Excellent English communication skills (written and spoken).
- Highly detail-oriented, organized, and able to manage multiple tasks in a fast-paced environment.
- Comfortable making professional collections calls to clients and payers.
- Ability to work 8:00 a.m. – 5:00 p.m. PST (night shift in South Africa).
Insurance: Claims Consultant
Posted 3 days ago
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Insurance: Claims Consultant – Emporium
Emporium – Roodepoort, Gauteng, South Africa
Salary: R160,000 – R200,000 CTC + performance‑based bonus
Location: Roodepoort, Gauteng, South Africa
Closing Date: 15 September 2025
Key Responsibilities- Administer and open new claim files
- Manage day‑to‑day processing and follow‑up of claims
- Appoint and authorise assessors where required
- Direct claims data entry and management on internal systems
- Ensure all controls are in place for valid claim settlements
- Manage repudiations with fairness and professional communication
- Apply policy terms and conditions accurately and consistently
- Contribute to ad hoc projects as required
- Matric with an A‑grade average (especially in Mathematics)
- BA or BCom degree
- Exceptional attention to detail and analytical skills
- Strong interpersonal and communication skills
- Ability to work effectively in a competitive and fast‑paced environment
- Hands‑on approach with a proactive attitude
- Strong, confident personality
If you meet the above criteria and are ready to take your hospitality career to the next level, please send your updated CV to .
Use reference: Insurance: Claims Consultant - POS25208 in the subject line of your email.
Please note: Should you not hear from us within 21 working days, kindly consider your application unsuccessful.
We take every measure to ensure your personal information is securely stored in our database, in line with data protection regulations.
#J-18808-LjbffrInsurance Claims Consultant
Posted 7 days ago
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Job Description
Insurance: Claims Consultant - POS25208
Based: Roodepoort
Salary: R160,000 and R200,000 CTC + Performance based bonus
We are seeking a highly intelligent, detail-oriented, and resilient individual to join our clients Claims Services team. This role involves managing the full claims process for short-term insurance clients, ensuring accuracy, fairness, and excellent customer service throughout. The ideal candidate thrives in a competitive environment, works well under pressure, and has outstanding interpersonal skills.
Minimum Requirements:
- Matric with an A-grade average (especially in Mathematics)
- BA or BCom degree
- Exceptional attention to detail and analytical skills
- Strong interpersonal and communication skills
- Ability to work effectively in a competitive and fast-paced environment
- Hands-on approach with a proactive attitude
- Strong, confident personality
Key Responsibilities:
- Administer and open new claim files
- Manage day-to-day processing and follow-up of claims
- Appoint and authorise assessors where required
- Direct claims data entry and management on internal systems
- Ensure all controls are in place for valid claim settlements
- Manage repudiations with fairness and professional communication
- Apply policy terms and conditions accurately and consistently
- Contribute to ad hoc projects as required
Closing Date: 31 October 2025
How to Apply
If you meet the above criteria and are ready to take your hospitality career to the next level, please send your updated CV to
Insurance Claims Consultant
Posted 13 days ago
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Job Description
Insurance: Claims Consultant - POS25208
Based: Roodepoort
Salary: R160,000 and R200,000 CTC + Performance based bonus
We are seeking a highly intelligent, detail-oriented, and resilient individual to join our clients Claims Services team. This role involves managing the full claims process for short-term insurance clients, ensuring accuracy, fairness, and excellent customer service throughout. The ideal candidate thrives in a competitive environment, works well under pressure, and has outstanding interpersonal skills.
Minimum Requirements:
- Matric with an A-grade average (especially in Mathematics)
- BA or BCom degree
- Exceptional attention to detail and analytical skills
- Strong interpersonal and communication skills
- Ability to work effectively in a competitive and fast-paced environment
- Hands-on approach with a proactive attitude
- Strong, confident personality
Key Responsibilities:
- Administer and open new claim files
- Manage day-to-day processing and follow-up of claims
- Appoint and authorise assessors where required
- Direct claims data entry and management on internal systems
- Ensure all controls are in place for valid claim settlements
- Manage repudiations with fairness and professional communication
- Apply policy terms and conditions accurately and consistently
- Contribute to ad hoc projects as required
Closing Date: 31 October 2025
How to Apply
If you meet the above criteria and are ready to take your hospitality career to the next level, please send your updated CV to
Insurance Claims Manager
Posted today
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- Application Deadline: 5 November 2025
- Job Location: Johannesburg, Gauteng
- Job Title: Insurance Claims Manager
- Education Level: Certificate
- Job Level: Management
- Minimum Experience: Years
We are looking for a dynamic, hands-on Head of Claims with 6–10 years' experience in the short-term insurance industry, the majority of which should be within the claims environment.
You'll bring both leadership and operational depth — someone who can drive strategy and lead teams, but who also understands the nuances of claims workflows, client service, and insurer engagement.
This is a role for someone who thrives in a fast-paced, empowered environment — someone who can make decisions, solve problems, and constantly challenge the status quo to make our claims experience best-in-class.
Salary on offer: Negotiable based on experience.
Duties and Responsibilities:
- Leadership & Strategy
- Lead and manage the entire Claims Department across all lines of business.
- Develop and execute claims strategies aligned with company growth and service goals.
- Empower, mentor, and hold your team accountable for performance and client outcomes.
- Drive innovation and continuous improvement in claims processes and customer experience.
- Operational Excellence
- Oversee front-end claims management and ensure efficient turnaround times.
- Identify process gaps and implement practical, measurable solutions.
- Maintain strong relationships with insurer partners, assessors, and service providers.
- Ensure claims compliance with all binder and regulatory obligations.
- Culture & Collaboration
- Actively contribute to the leadership team — challenging and supporting where needed.
- Foster a positive, high-performance culture that reflects Bsure's values of empowerment, integrity, and accountability.
- Be proactive in suggesting restructuring, process improvements, or new initiatives that drive better outcomes for clients and teams.
- Performance & Reporting
- Monitor and manage claims ratios, turnaround times, and customer satisfaction metrics.
- Provide data-driven insight and recommendations to the executive team.
- Ensure operational reporting and performance tracking is accurate, clear, and actionable.
Requirements:
- 6–10 Years' experience in short-term insurance, with a significant portion in claims.
- Proven leadership or management experience within a claims environment.
- Strong understanding of insurer relationships, binder structures, and compliance requirements.
- Excellent communication, problem-solving, and decision-making skills.
- Able to operate autonomously while collaborating across multiple departments.
- Driven, accountable, and motivated by results and continuous improvement.
Insurance Claims Manager
Posted today
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Job Description
Bsure Insurance Advisors is one of South Africa's most progressive and people-centric brokerages. We partner with a multitude of insurers and handle key binder functions across underwriting, claims management, and renewals — all while maintaining an obsessive focus on service, empowerment, and culture.
We don't micromanage. We believe in accountability, execution, and ownership. Our leaders operate with autonomy and integrity, constantly looking for better ways to structure, improve, and evolve the business.
We are looking for a dynamic, hands-on Head of Claims with 6–10 years' experience in the short-term insurance industry, the majority of which should be within the claims environment. You'll bring both leadership and operational depth — someone who can drive strategy and lead teams, but who also understands the nuances of claims workflows, client service, and insurer engagement.
This is a role for someone who thrives in a fast-paced, empowered environment — someone who can make decisions, solve problems, and constantly challenge the status quo to make our claims experience best-in-class.
Key Responsibilities
Leadership & Strategy
• Lead and manage the entire Claims Department across all lines of business.
• Develop and execute claims strategies aligned with company growth and service goals.
• Empower, mentor, and hold your team accountable for performance and client outcomes.
• Drive innovation and continuous improvement in claims processes and customer experience.
Operational Excellence
• Oversee front-end claims management and ensure efficient turnaround times.
• Identify process gaps and implement practical, measurable solutions.
• Maintain strong relationships with insurer partners, assessors, and service providers.
• Ensure claims compliance with all binder and regulatory obligations.
Culture & Collaboration
• Actively contribute to the leadership team — challenging and supporting where needed.
• Foster a positive, high-performance culture that reflects Bsure's values of empowerment, integrity, and accountability.
• Be proactive in suggesting restructuring, process improvements, or new initiatives that drive better outcomes for clients and teams.
Performance & Reporting
• Monitor and manage claims ratios, turnaround times, and customer satisfaction metrics.
• Provide data-driven insight and recommendations to the executive team.
• Ensure operational reporting and performance tracking is accurate, clear, and actionable.
⸻
Requirements
• 6–10 years' experience in short-term insurance, with a significant portion in claims.
• Proven leadership or management experience within a claims environment.
• Strong understanding of insurer relationships, binder structures, and compliance requirements.
• Excellent communication, problem-solving, and decision-making skills.
• Able to operate autonomously while collaborating across multiple departments.
• Driven, accountable, and motivated by results and continuous improvement.
⸻
Who You Are
• Dynamic, decisive, and take ownership of outcomes.
• You don't need to be micromanaged — you manage your space, your people, and your results.
• Thrive in a culture that values empowerment, execution, and personal accountability.
• Love working with people, solving problems, and finding better ways to do things.
• Understand that leadership means both guarding and growing your team.
⸻
Why Bsure
At Bsure, our people are the priority.
We work hard, grow fast, and build together. You'll be joining a culture that believes in genuine empowerment, high accountability, and mutual respect — all in a team that's constantly expanding its footprint in the short-term insurance space.
Insurance: claims consultant
Posted today
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Motor Insurance Claims Consultant
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? Motor Claims Consultant – George, South Africa
Join Pacific International Insurance – Where Compassion Meets Excellence
Pacific International Insurance is an Australian-based company, proudly serving customers in Australia and New Zealand through our flagship brand, PD Insurance. We specialise in pet and motor insurance, and we’re excited to be expanding our South African branch!
We’re on the lookout for a service-driven, empathetic, and proactive Motor Claims Consultant to join our growing team in George. If you’re passionate about helping people and thrive in a fast-paced, customer-focused environment, we’d love to hear from you!
Why This Role MattersAs a Motor Claims Consultant, you’ll play a key role in ensuring claims are processed accurately, efficiently, and compassionately. You’ll help manage claims costs in line with policy guidelines, industry regulations, and delegated authorities. Most importantly, you’ll be the voice of our Soft Landings philosophy, delivering exceptional customer service from claim lodgement to closure.
Working Hours- Monday to Friday : 00h00 – 08h00 AM ( these hours are subject to change and rotational shifts may be applied to support the requirements of the business).
These hours align with our Australian clients, giving you more flexibility during your day.
Location: George, South Africa (on-site)
Be part of a global team with a local heartbeat.
Ready to make a difference in people’s lives while growing your career?
Apply now and become part of a company that values compassion, collaboration, and continuous improvement.
#J-18808-LjbffrMotor Insurance Claims Consultant
Posted today
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Job title: Motor Insurance Claims Consultant
Job Location: Western Cape, George
Deadline: November 08, 2025
Quick Recommended Links- Jobs by Location
- Job by industries
- As a Motor Claims Consultant, you’ll play a key role in ensuring claims are processed accurately, efficiently, and compassionately.
- You’ll help manage claims costs in line with policy guidelines, industry regulations, and delegated authorities.
- Most importantly, you’ll be the voice of our Soft Landings philosophy, delivering exceptional customer service from claim lodgement to closure.
If you tick these boxes, we’d love to receive your application :
- Grade 12 / National Senior Certificate.
- Excellent written and verbal communication in English.
- Excellent computer skills.
- Previous experience in a customer service role.
- Strong attention to detail, organisational and admin skills.
- Willingness to work nightshift hours.
- Insurance jobs.
Short Term Insurance Claims
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Build Your Career with ICS in our Short-Term Insurance Claims Talent Pipeline (AUS Operations)
Are you a seasoned Short-Term Insurance professional ready for your next international opportunity?
At Insure-Connect Services (ICS), we're growing our talent pipeline for upcoming remote opportunities supporting Australian insurance brokers and firms.
While this isn't an immediate vacancy, we're proactively connecting with experienced candidates who want to be first in line when exciting roles open up - typically within
4 to 8 weeks
.
About ICS
ICS partners with international brokers and insurance firms to deliver top-tier claims and underwriting talent. As our global client base expands, we're building a strong, pre-qualified network of professionals ready to step into dynamic roles as soon as demand arises.
Role Snapshot
You'll handle
end-to-end claims administration
across
Commercial, Personal, and Motor Lines
, supporting brokers and clients to ensure seamless, compliant, and efficient claims resolution - all while maintaining world-class service standards.
What You'll Do
- Manage claims from first notification to final settlement.
- Validate coverage, assess claims, appoint assessors, and drive resolution.
- Maintain detailed records and ensure compliance with insurer and regulatory standards.
- Liaise professionally between clients, brokers, and insurers to ensure clarity and timeliness.
- Support cost control and process efficiency through accurate documentation and follow-ups.
You'll thrive if you enjoy:
Problem-solving and keeping things running smoothly, clear communication, client satisfaction and working independently in your own structured and remote setup.
What We're Looking For
- Matric (Grade 12)
or equivalent NQF4 qualification. - 3+ years' experience
in Short-Term Insurance Claims (Commercial, Personal, and Motor). - Strong communication skills and professional English.
- Confident using claims management systems and MS Office.
- Reliable remote setup with stable power and internet (loadshedding-ready).
Why Join Our Talent Network?
- Be first in line for international remote roles as soon as they become available.
- Work with well-established AUS brokers and insurance partners.
- Gain international exposure while working from South Africa.
- Enjoy structured onboarding, growth opportunities, and continuous learning.
If you're ready to grow your career and connect with leading global insurers - join the ICS Talent Network today