Momentum Vacancies for Nurses – Professional Nurse

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.

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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

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Apply Here

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