Healthcare Cost Controller

6 days ago


Pretoria, Gauteng, South Africa Bestmed Medical Scheme Full time
Job Description

This role involves delivering cost-effective managed healthcare services to achieve member satisfaction. The ideal candidate will possess excellent client relations skills, able to assist clients by approving appropriate funding.

The successful candidate will provide an effective call centre service to achieve member satisfaction, reducing risk associated with hospital and authorised cases. They will answer telephone calls in a manner that achieves member satisfaction and verify prosthesis limits to contain costs for both members and funds.

Ongoing training and development are essential in updating knowledge and skills to deliver a cost-effective and professional service. The actual benefit expenditure per beneficiary per month for hospitalisation should be less than the budget benefit expenditure, and pre-authorisation should be granted within option benefits, scheme, and clinical protocols.



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