Job Description
Golden Knot Medical Aid Society (GKMAS) invites applications from suitably experienced individuals for the position of Claims Clerk / Adjudicator. This position reports directly to the Principal Officer, GKMAS, and is offered on a renewed fixed-term contract basis.
This role is targeted at semi-retired or retired claims professionals — seasoned veterans of the medical aid claims environment who bring deep, hands-on expertise and are seeking a meaningful, part-time or full-time role that puts decades of experience to good use.
Duties and Responsibilities
● Adjudicate medical claims against AHFOZ and non-AHFOZ tariffs with accuracy and consistency.
● Maintain and update the Drug Master File in line with current pricing and formulary changes.
● Liaise with the Medical Services Provider Network on claims-related queries and provider account matters.
● Apply claims and benefits accounting principles correctly across member accounts.
● Apply waiting period rules accurately to new and existing membership claims.
● Verify that all claims payments are fully justified before approval, safeguarding the Society against irregular or fraudulent payments.
● Report directly to, and support, the Principal Officer, GKMAS, on claims administration matters.
Qualifications and Experience
● Must be semi-retired or retired, with a proven track record in medical aid claims administration.
● Must hold a valid Class 4 Driver's Licence.
● A veteran of medical claims tariffs, with sound working knowledge of both AHFOZ and non-AHFOZ tariff structures.
● Demonstrated experience in Drug Master File management.
● Strong working knowledge of the Medical Services Provider Network and provider relationships.
● Competence in claims and benefits accounting.
● Sound understanding of waiting periods and their correct application to claims.
● A meticulous eye for ensuring all claims payments are justified, accurate, and compliant before disbursement
How to Apply
Interested candidates who meet the above requirements should submit a detailed CV, certified copies of qualifications, and a copy of a valid Class 4 Driver's Licence to the Principal Officer, GKMAS, at hr@goldenknot.co.zw not later than 23 August 2026 quoting "Claims Clerk / Adjudicator" in the subject line.
Golden Knot Medical Aid Society is an equal opportunity employer. Only shortlisted candidates will be contacted.
