A reputable Medical Aid is seeking Pre-Authorisation Consultants to join their Call Centre team in Pretoria. (Office Hours, Mon-Friday)
Duties:
Client Relations:
Assist the client by approving appropriate funding.
To deliver an effective Call centre service in order to achieve member satisfaction.
Risk Management:
Reduce the risk associated with hospital and authorized cases
Telephone Etiquette
: Answering telephone calls in a way that achieves member satisfaction.
Verifying prosthesis limits:
Contain costs for both members and fund.
On-going training and development
: Update your knowledge and skills in order to deliver a cost-effective and professional service.
To ensure that the actual benefit expenditure per beneficiary, per month, for hospitalization, should be less than the budget benefit expenditure
Pre-authorization should be granted within the option benefits, Scheme and clinical protocols.
Effective Customer Service delivery.
Requirements:
Grade 12
SANC Registered Nurse
5 Years Clinical Nursing experience (After completing Community Service) within Theatre/ ICU/ Trauma wards
1 year Medical Aid Scheme industry experience (Advantageous)
What is your monthly salary expectation? (Before deductions)
Are you 100% Computer Literate? (MS Office / Internet / Email)
Are you willing to be based and work in Pretoria? (This role is office based, in Pretoria)
Do you have a minimum of 5 years experience in (Theatre/ICU/Trauma) after completing your Community Service?
License/Certification:
SANC (Required)
Work Location: In person
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