Medical Pre-Authorization Expert

3 days ago


Pretoria, Gauteng, South Africa Medical Resources Group Full time

**Our Mission**

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At Medical Resources Group, we strive to provide innovative solutions to our members while upholding the highest standards of quality service. As a Pre-Auth Consultant – Enrolled Nurse, you will play a vital role in ensuring the delivery of cost-effective managed healthcare services.

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About the Role:

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This is an exciting opportunity to join a dynamic team where you will utilise your clinical expertise and negotiation skills to facilitate the pre-authorisation process. You will be responsible for maintaining accurate record-keeping and documentation, providing cost-effective managed healthcare services primarily through email correspondence, and utilising strong writing skills in both Afrikaans and English to effectively communicate with members.

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Key Responsibilities:

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  • \
  • Employ negotiation skills to facilitate the pre-authorisation process.\
  • Maintain accurate record-keeping and documentation of pre-authorisation requests.\
  • Provide cost-effective managed healthcare services primarily through email correspondence.\
  • Utilise strong writing skills in both Afrikaans and English to effectively communicate with members.\
  • Utilise computer skills and knowledge of MS Word, MS Excel, MS Office, Outlook, and Internet applications.\
  • Demonstrate strong organisational skills, attention to detail, and ability to prioritise tasks effectively.\
  • Maintain strong interpersonal communication skills and effectively work within a team environment.\
  • Demonstrate a caring attitude and behaviour towards members.\
  • Adapt to change and management decisions to achieve common goals.\
  • Utilise problem-solving techniques to address member queries and concerns.\
  • Provide training to staff on a continual basis and demonstrate leadership skills.\
  • Take responsibility for tasks and foster good interpersonal relationships with staff.\
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Requirements:

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The ideal candidate will have a Grade 12 qualification, Enrolled Nurse certification, active SANC membership, and at least 5 years' experience as a nursing practitioner, as well as at least 1 year of experience in the medical funding industry.

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Skills and Qualifications:

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  • \
  • Strong writing skills in English.\
  • Computer skills and knowledge of MS Word, MS Excel, MS Office, Outlook, and Internet applications.\
  • Strong organisational skills, attention to detail, and ability to prioritise.\
  • Strong negotiation skills.\
  • Language skills in English and strong interpersonal communication skills.\
  • Ability to work with people and be a team player.\
  • Caring attitude and behaviour.\
  • Strong sense of self-esteem and confidence.\
  • Flexibility in adapting to change and management decisions in order to achieve common goals.\
  • The application of problem-solving techniques.\
  • Ability in record keeping and documentation.\
  • Prepared to train staff on a continual basis.\
  • Leadership skills.\
  • Taking responsibility and maintaining good interpersonal relationships with staff.\
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What We Offer:

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We offer a comprehensive benefits package, including a competitive salary, generous leave entitlements, and access to our state-of-the-art facilities. Join us today and take the first step towards a rewarding career in healthcare.



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