Pre-authorisation Consultant - Pretoria, South Africa - Medpharm Recruitment

Medpharm Recruitment

Verified Company

Pretoria, South Africa

1 week ago

Posted by:

Thabo Mthembu

beBee Recruiter

A reputable Medical Aid Scheme, based in Pretoria, is seeking a Pre-Authorisation Consultant to join their Hospital Benefit Management team.

Duties:

Delivering costeffective managed healthcare services to accomplish member satisfaction.
Assisting the Client by approving appropriate funding.
Delivering an effective Call Centre service in order to achieve member satisfaction.
Reducing the risk associated with hospital and authorized cases
Answering telephone calls in a way that achieves member satisfaction.
Verifying prosthesis limits by containing costs for both members and fund.
Ongoing training and development: Updating knowledge and skills in order to deliver a costeffective and professional service.
Confirming the actual benefit expenditure per beneficiary, per month for hospitalization should be less than the budget benefit expenditure.
Ensuring that preauthorization should be granted within the option benefits, Scheme and clinical protocols.
Delivering an effective call centre service in order to achieve member satisfaction.

Requirements: