Job Description

Role Overview

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We are seeking a detail-oriented

Medical Aid Verification of Benefits (VOB) Administrator

to verify patient medical aid cover, benefits, and authorisations prior to medical services being rendered.


The role ensures accurate benefit verification, reduces claim rejections, and supports smooth billing and patient communication.


This position is critical in ensuring that medical services are aligned with the patients available benefits and medical aid rules.

Key Responsibilities

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Medical Aid & Benefits Verification

Verify

medical aid membership status

and plan eligibility Confirm

covered benefits

for consultations, procedures, and treatments Check

annual limits

, sub-limits, PMB eligibility, and exclusions Identify

co-payments

, deductibles, and out-of-pocket costs Confirm

network status

(DSP / in-network vs out-of-network)
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Authorisations & Pre-Approvals

Determine when

pre-authorisation

is required Assist with or submit

authorisation requests

where needed Track approval reference numbers and validity periods
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Documentation & Communication

Accurately document verified benefits and authorisations Communicate benefit details clearly to internal teams and/or patients Liaise with

medical aids, administrators, and scheme call centres

Maintain organised records for billing and audit purposes
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Billing & Claims Support

Support billing teams by ensuring services align with verified benefits Reduce claim rejections through proactive verification Assist with claim follow-ups related to eligibility or benefit disputes

Requirements

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Experience

1-3+ years experience in:

+ Medical aid administration
+ Medical billing or healthcare admin
+ Verification of Benefits (VOB) or eligibility checks

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Knowledge

Strong understanding of South African medical aid schemes Familiarity with:

+ PMBs (Prescribed Minimum Benefits)
+ DSP rules
+ Pre-authorisations and benefit structures

###

Skills

High attention to detail and accuracy Strong verbal and written communication skills Ability to handle confidential patient information Comfortable working with portals, spreadsheets, and practice systems Able to work independently and meet deadlines

Advantageous (Not Essential)

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Experience supporting

international (US) healthcare billing

* Knowledge of medical coding (ICD-10, CPT - basic exposure)