Medical Aid Pre-Authorisation Officer

4 weeks ago


Johannesburg, South Africa Affinity International Full time

Overview We are looking for a Medical Aid Pre-Authorisation Officer for one of our clients. In this role, you will be responsible for securing pre-authorisations from medical aids, verifying patient benefits, and ensuring all services are cleared for cover before treatment takes place. You will play a key role in preventing claim rejections and ensuring smooth coordination between patients, providers, and medical aids. Key Responsibilities Obtain pre-authorisations from medical aids for scheduled procedures and treatments. Verify patients membership, benefits, and eligibility prior to appointments. Collect and submit the required clinical documentation for pre-authorisation requests. Track pending authorisations and follow up to ensure timely approvals. Communicate authorisation outcomes to doctors, billing, and scheduling staff. Record all authorisation and verification activities accurately in the practice management/EMR system. Handle pre-authorisation denials by submitting additional information or lodging appeals where needed. Stay up to date with medical aid rules, authorisation processes, and policy changes. Qualifications Minimum of 2 years experience in medical aid pre-authorisations and benefits verification. Solid understanding of South African medical aid schemes, rules, and clinical terminology. Proficiency in EMR/practice management and billing systems. Strong attention to detail and excellent organisational skills. Clear communication skills for liaising with medical aid representatives, doctors, and patients. Ability to work independently and manage multiple priorities. Familiarity with CentralReach is an advantage but not required. #J-18808-Ljbffr



  • Johannesburg, South Africa Affinity International Full time

    Overview We are looking for a Medical Aid Pre-Authorisation Officer for one of our clients. In this role, you will be responsible for securing pre-authorisations from medical aids, verifying patient benefits, and ensuring all services are cleared for cover before treatment takes place. You will play a key role in preventing claim rejections and ensuring...


  • Johannesburg, South Africa Affinity International Full time

    **Overview**: We are looking for a **Medical Aid Pre-Authorisation Officer** for one of our clients. In this role, you will be responsible for securing pre-authorisations from medical aids, verifying patient benefits, and ensuring all services are cleared for cover before treatment takes place. You will play a key role in preventing claim rejections and...


  • Johannesburg, South Africa Talent Pal Full time

    A Medical Insurance Company based in Benoni is looking for a Pre-Authorisation Nurse who will assess the authenticity and legitimacy of requests for medical services or treatment by members or service providers in a timely, effective, efficient, equitable and client centred manner. **Key Performance Areas** - Authorise or Decline Medical Services or...

  • Medical Advisor

    1 week ago


    Johannesburg, South Africa Medical Placements Full time

    EE Position - The position report directly to the HOD: Hospital Benefit Management. **THE IDEAL CANDIDATE SHOULD HAVE**: - Must be a Medical Doctor registered with Health Professions Council of South Africa (HPCSA). - Medical indemnity insurance will be an added advantage. - Must have sound knowledge of the Medical Aid Industry, Rules & Regulations, and...


  • Johannesburg, South Africa Unique Personnel Full time

    **Job Number** - 68435 **Job Type** - Permanent **Job Title** - Medical Aid Sales Rep **Computer Skills** - MS Word **Industry** - Financial Services **City** - Johannesburg South **Province** - Gauteng - Phone prospects and quote on various medical aid options (existing Company client’s and leads)- Following up on information sent and answering all...


  • Johannesburg, South Africa Medical Placements Full time

    **Job Title**:PA & Medical Receptionist to Specialist Psychiatrist **Experience Required**: minimum 3-4 years working as a medical receptionist. **Employment type**:Full Time, onsite **Salary**:R15 000 gross per month (no benefits) **Hours**:8:30 am to 5pm (Mon-Fri), 1 hour lunch break - **Must be above 35 years old **and want to stay in a career as a...


  • Johannesburg, South Africa National Renal Care Full time

    National Renal Care is a leading comprehensive kidney disease management provider in South Africa. Our organisation fosters a collaborative work environment where compassion, digital innovation, and clinical excellence merge to deliver high-quality care to individuals with compromised organ function. At National Renal Care, we are committed to being an...


  • Johannesburg, South Africa National Risk Managers (Pty) Ltd Full time

    A Medical Insurance company based in Benoni is looking for a Manager to Manage the Pre-Auth and Claims department. The Manager will manage the accurate and timely processing of claims within established legal and company compliance guidelines. Manage the pre-authorisation department and facilitate the process of pre-authorisation as per requests from members...


  • Johannesburg, South Africa Legal Aid South Africa Full time

    Overview Legal Aid SA is a national public entity; a key contributor to South Africa's constitutional democracy, providing quality legal services to poor and vulnerable persons. The organisation has a national footprint. Legal Aid SA is an accredited Top Employer SA for 11 consecutive years – a credible employer of choice. Its culture is rooted in...

  • New and Pre

    2 days ago


    Johannesburg, South Africa Protea Placements Full time

    **New and Pre-Owned Vehicle Sales Executive** **Johannesburg** **Negotiable + Commission** **Company vehicle, 50% contribution to medical aid & provident fund** **Requirements**: - Matric certification - Valid driver’s license - Previous sales experience within the motor industry - At least 3- 5 years’ experience in vehicle sales - Mahindra experience...