Medical Debtors Clerk - Pretoria East
Qetello Holdings
Location: Pretoria East, Gauteng
Industry: Medical Billing | Healthcare Administration
Employment: Permanent Position
An established medical billing bureau is looking to appoint a detail-oriented and experienced Medical Debtors Clerk to support its medical billing, claims, and debtors operations.
This position is suited to an individual with a strong background in medical billing and debtors management, including direct billing experience for Anaesthesiologists and Gynaecologists. The successful candidate must be able to work accurately under pressure, meet strict deadlines and manage assigned account portfolios effectively.
The role focuses on accurate claim submission and follow-up, ensuring optimal settlement timelines while maintaining professional and ethical engagement with patients, medical schemes and third-party funders.
Key Responsibilities
Administrative and Billing Functions
• Capture, process and manage medical claims accurately and timeously.
• Allocate and manage assigned medical practices and their full account portfolios.
• Perform direct billing for Anaesthesiologists and Gynaecologists.
• Ensure correct tariff coding, modifier use, billing compliance and supporting documentation according to discipline-specific requirements.
• Maintain accurate electronic and manual patient records.
• Perform general administrative duties relating to medical billing and claims management.
Debtors and Collections
• Follow up on outstanding claims with medical schemes, patients and third-party funders.
• Resolve rejected claims, short payments, outstanding information and account queries efficiently.
• Monitor account ageing and implement proactive collection strategies.
• Liaise professionally with medical schemes, funders, healthcare practitioners and patients by telephone and email.
• Support the company’s objective of achieving claim settlement within 30 days of service delivery.
Compliance and Quality Control
• SAMA guidelines
• SASA billing rules
• HPCSA regulations
• Medical scheme rules and Prescribed Minimum Benefit requirements
• Compensation Commissioner requirements
• Other relevant third-party payer rules
• Adhere strictly to company policies, procedures and confidentiality standards.
• Maintain a high level of accuracy and quality across all billing and debtors functions.
• Identify and escalate billing trends, recurring rejections and operational risks
Minimum Requirements
• Matric or Grade 12
• At least two to three years’ recent experience in medical billing, debtors or healthcare administration
• Direct billing experience for Anaesthesiologists and Gynaecologists
• Working knowledge of medical schemes, claims processes and specialist billing requirements
• Knowledge of ICD-10 coding, tariff codes, billing modifiers and medical scheme rules
• Experience managing rejected claims, short payments, follow-ups and resubmissions
• Experience using medical billing systems such as Elixir, E-Live, switching platforms and medical scheme portals
• Proficiency in Microsoft Outlook, Word and Excel
Key Competencies and Skills
• Exceptional attention to detail and accuracy
• Strong written and verbal communication skills
• Excellent planning, organising and follow-up abilities
• Ability to work independently and collaboratively within a team
• Strong time-management skills and the ability to meet strict deadlines
• Ability to use initiative when resolving billing and operational challenges
• Professional, ethical and discreet handling of confidential information
• Resilience and the ability to work effectively under pressure
Company Values and Behavioural Expectations
• Proactive – Anticipating and resolving issues before escalation
• Efficient – Delivering accurate work within agreed timelines
• Accurate – Maintaining precision in all billing and data-capturing activities
• Honest – Acting with integrity and transparency
• Respectful – Maintaining professional relationships with all stakeholders
• Dynamic and Adaptable – Responding positively to change
• Creative – Identifying opportunities to improve processes and service delivery
What Is on Offer
• Market-related remuneration
• Medical aid and pension or provident fund, where applicable
• Performance incentives
• A stable and professional healthcare environment
To Apply
Subject line/reference: Medical Debtors Clerk
Please note that only candidates with direct billing experience for Anaesthesiologists and Gynaecologists will be considered.
Should you not receive feedback within two weeks of submitting your application, please consider your application unsuccessful.
