Pre-Authorization Manager

3 days ago


Nelspruit, Mpumalanga, South Africa Mediplus SA Full time

The Clinical Benefits Agent role at Mediplus SA requires an individual who can effectively communicate with members, client relations, and healthcare providers to ensure optimal patient care. Key responsibilities include managing pre-authorizations, coordinating case management, acting as a liaison, and negotiating tariffs.

Required Skills and Qualifications
  • Matric with mathematics.
  • Diploma in risk or clinical nursing advantageous.
  • Knowledge of Anatomy and Physiology.
  • Previous experience in case management, pre-authorizations, or a similar role strongly advantageous.
  • Strong negotiation and communication skills.
  • Ability to manage multiple tasks and work under pressure.
  • Knowledge of healthcare regulations and compliance requirements strongly advantageous.
  • Proficiency in using case management software, ICD-10 codes, and procedure codes strongly advantageous.
  • Excellent interpersonal skills and attention to detail.
  • Reliable, professional, and able to work collaboratively within a diverse team.
  • Knowledge of COID, medical aid rules, and managed healthcare policies.

Mediplus SA offers a collaborative work environment, opportunities for professional growth, and competitive compensation and benefits.



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