Job Description: To effectively contribute to the Hospital Pre-Auth Team, ensuring that the KPI’s and SLA’s are met and that hospital procedures are authorised according to protocol. [the_ad id="21943"] Job Responsibilities: Be part of a culture that directs best practice, fostering an environment of continuous learning, improvement and cohesiveness Assistance with clinical related queries and escalations where applicable Accurately resolve client queries and ensure excellent client service Demonstrate exemplary team behaviour through personal involvement, commitment and dedication in support of organisational values Running of daily reports and distribution to the applicable case managers Presenting of complicated cases at clinical meetings when required Pre-authorisation of all in-hospital procedures for applicable schemes, according to CRM protocols, telephonically and via email Pre-authorisation of all specialised radiology for all schemes, according to CRM protocols Accurate and comprehensive recording of notes on the system Pre-authorisation of all medical appliances and oxygen for all schemes Job Requirements: Language proficiency in English, Afrikaans and one other South African language - Advantageous Understanding of the Medical Scheme Industry - Advantageous Exposure to claims and ICD-10 coding - Advantageous Valid South African Nursing Council Registration - Essential Qualification & Experience: Degree / Diploma in General Nursing - Essential 1-2 Years' experience in a private hospital - Essential Relevant experience in a call centre environment - Advantageous Matric / Grade 12 / National Senior Certificate - Essential MS Office Suite Experience - Essential Job Details: Company: Momentum Vacancy Type: Full Time Job Location: Port Alfred, Eastern Cape, South Africa Application Deadline: N/A [the_ad id="21944"] Apply Here jobsrican.com
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