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Nurse Healthcare Authoriser
1 week ago
**Job Summary:**
We are seeking a skilled Clinical Authorisation Consultant to join our team at the Medical Resources Group. The successful candidate will have a strong background in nursing and experience in managed healthcare or private hospital settings.
**Responsibilities Include:**
- Application Review: Evaluate pre-authorisation applications to determine eligibility and scope of benefits.
- Telephonic Authorisations: Handle pre-authorisations through the call center, providing clear and relevant information to patients and service providers.
- Data Entry & Verification: Accurately capture and verify clinical details, including ICD-10 and item codes, to maintain accurate records of all transactions and documentation.
- Membership Validation: Confirm membership status and available benefits prior to granting authorisation.
**Requirements:**
- Education: Minimum Grade 12 certificate.
- Nursing Qualification: Degree or diploma in nursing; registered with SANC.
- Experience: At least two years in a private hospital or managed healthcare setting.
