Credit Controller Medical Industry – (SSCCMI)

Main job function

The Credit Controller will be responsible for managing the debtors’ function within the medical industry, ensuring efficient collections, accurate account reconciliation, and timely resolution of account queries. This role requires strong knowledge of medical billing systems, medical aid schemes, and reimbursement processes. The successful candidate will work closely with doctors, patients, and medical aid providers to optimize cash flow, minimize outstanding debt, and ensure compliance with healthcare regulations.

Minimum Qualifications & Requirements

• Matric (Grade 12) certificate (essential)
• Minimum of 3 years’ experience in medical credit control (essential)
• Proficiency in Microsoft Office (Excel, Word, Outlook) and medical billing software (e.g., Elixir Live, MedEDI, iHealth, Vericlaim, GoodX)
• Strong understanding of medical billing processes and reimbursement methods
• General knowledge and understanding of ICD coding
• Knowledge of SAMA billing guidelines and medical aid scheme rules (advantageous)
• Experience with WCA and eCOIDA processes (highly advantageous)
• Experience with paper claim submissions (advantageous)

Key Responsibilities

• Follow up on outstanding claims and payments, ensuring overdue accounts are addressed efficiently.
• Validate patient account charges, reconcile invoices, and resolve
• Perform detailed aged debt analysis and maintain comprehensive age analysis notes on all outstanding accounts
• Maintain accurate aged debt reports and provide regular updates to management
• Manage and resolve patient account queries and disputes professionally and efficiently
• Escalate and manage PMB (Prescribed Minimum Benefit) queries and disputes where applicable
• Liaise directly with medical aid schemes and patients to resolve payment queries and disputes
• Maintain knowledge and accurate records of each doctor’s DSP (Designated Service Provider) arrangements and requirements
• Submit electronic and paper claims where required and ensure proper recordkeeping of submissions
• Implement and refine credit control procedures to optimize cash flow and reduce outstanding debt
• Prepare detailed reports on collections performance, write-offs, escalations, and recovery trends
• Ensure billing and collection practices comply with healthcare regulations, medical aid scheme requirements, and company policies
• Work closely with the billing team to support claim resubmissions, appeals, and adjustments where required
• Contribute to internal audits by maintaining accurate, up-to-date financial and patient records
• Develop strong working relationships with stakeholders (doctors, patients, medical schemes and billing team) to foster trust and collaboration.
• Escalate high-risk accounts and provide recommendations for legal action, settlements, or write-offs.

Key Competencies

• Strong financial acumen and proven debt recovery skills within the medical sector
• Excellent communication (written and verbal) and negotiation skills
• High level of accuracy, attention to detail, and problem-solving ability

A Consultant will be in touch if you are shortlisted for the position. Please consider your application unsuccessful should you not have been contacted within 2 weeks. We will keep your CV on our database and contact you should you match the criteria of any other vacancies.