Pre-authorisation Consultant - Pretoria, South Africa - HRInsync

HRInsync

Verified Company

Pretoria, South Africa

1 week ago

Posted by:

Thabo Mthembu

beBee Recruiter

Description

Company
One of the largest private Medical Aid companies in SA. They have been established for 20 years and are striving to be #1 in SA.

Purpose
Delivering cost-effective managed healthcare services to accomplish member satisfaction.

Responsibilities:

Client Relations, To assist the client by approving appropriate funding
To deliver an effective call centre service in order to achieve member satisfaction
Risk Management, To reduce the risk associated with hospital and authorized cases
Telephone Etiquette, Answering telephone calls in a way that achieves member satisfaction
Risk Management, To reduce the risk associated with hospital and authorized cases
Verifying prosthesis limits, To contain costs for both members and fund
Ongoing training and development, To update knowledge and skills in order to deliver a costeffective and professional service
The actual benefit expenditure per beneficiary per month for hospitalization should be less than the budget benefit expenditure
Preauthorization should be granted within the option benefits, Scheme and clinical protocols
Effective Customer Service delivery
To deliver an effective call centre service in order to achieve member satisfaction
Delivering a costeffective Managed Healthcare service

Requirements: