Deliver appropriate information to healthcare users.
Educate members of potential side effects to medication
Provide members with information and advice on prescribed over the counter medication.
Perform administrative duties.
Improve areas identified by the QA
Continue with ongoing Learning and Development to stay abreast with healthcare industry
Capture of accurate clinical records on system
Provide effective communication to encourage and maintain behavioural
Script to schedule 4, when clinically appropriate
Issue Sick notes when clinically appropriate
Adhere to time and
Secondary Tasks / Activities
Prioritize incoming authorization requests and/or queries according to urgency.
Assess pre-authorisation requests for GP visits, specialist visits, emergency room visits, diagnostic procedures, hospitalisation for illness and accident events, including the appropriate facilities (day clinics, sub-acute facilities, home nursing and preferred providers)
To check the reasons for authorisation and documentation received are appropriate and confirm if it according to set protocols, guidelines, formularies, and preferred provider agreements. Based on protocols approved or decline. If the reason for authorisation is not defined in the protocols or guidelines escalate the case for clinical review
Approve or decline benefits accurately according to the benefits per benefit option and strictly according to the protocols.
Other requirements
Registered with SANC
Call Centre experience
Dispensing Certificate
Essential Qualifications
Matric
Nursing Diploma/Degree
Desirable Qualifications
Dispensing Certificate
Essential Experience
Experience in clinical evaluation of patients signs and symptoms
IT system navigation
Desirable Experience
Primary Healthcare
Call Centre experience
Dispensing Certificate
Experience in issuing of scripts as per regulation
Experience in issuing of sick notes as per regulation
Knowledge and Skills
Extensive MS Office knowledge
Strong written and verbal communication skills
Good telephonic etiquette
Good listening skills
Strong administration skills
Knowledge in Primary Healthcare
Strong organisation skills
Good time management skills
Attributes
Holistic thinker
Critical thinker
Able to work under pressure
Team player
Compassionate
Honest, hardworking, and humble
Careers24
Beware of fraud agents! do not pay money to get a job
MNCJobs.co.za will not be responsible for any payment made to a third-party. All Terms of Use are applicable.