Healthcare Authorisation Consultant

2 days ago


Pretoria, Gauteng, South Africa Qetello Holdings Full time
About the Role:

We are seeking a highly skilled Healthcare Authorisation Consultant to join our team in Pretoria. The ideal candidate must hold a completed qualification as an Enrolled Nurse and be registered with SANC, boasting at least 2 years of experience in Managed Healthcare.

The successful candidate will be responsible for reviewing and processing pre-authorisation requests for various healthcare services. This includes evaluating clinical information, verifying ICD-10 and item codes, and preparing summaries of members' clinical histories for the medical advisor. They will also be responsible for monitoring the flow of documents between the pre-authorisation division and the medical advisor.

The estimated salary for this position is approximately R220,000 - R320,000 per annum, depending on experience. This figure takes into account the level of expertise required, the location, and the industry standards for similar roles.

This role requires excellent communication skills, both written and verbal, as well as proficiency in understanding Afrikaans spoken and written communication. Computer literacy in Ms Office is also essential. Additionally, the candidate should have good decision-making skills, be able to work independently, and handle conflict situations effectively.

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