Current jobs related to Medical Pre-Authorisation Specialist - Pretoria, Gauteng - Qetello Holdings


  • Pretoria, Gauteng, South Africa Qetello Holdings Full time

    Job Title: Medical Pre-Authorisation SpecialistIn collaboration with our esteemed client in Pretoria, Qetello Holdings is recruiting a skilled Medical Pre-Authorisation Specialist. The ideal candidate must possess a completed qualification as an Enrolled Nurse and be registered with SANC, boasting at least 2 years of experience in Managed Healthcare.The...


  • Pretoria, Gauteng, South Africa Qetello Holdings Full time

    **Job Overview:** Qetello Holdings seeks a skilled Clinical Pre-Authorisation Consultant to enhance its dynamic team. This role involves reviewing and evaluating pre-authorisation applications, ensuring seamless service delivery to healthcare providers and patients.**Responsibilities:**Review and process pre-authorisation applications with meticulous...


  • 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...


  • Pretoria, Gauteng, South Africa Qetello Holdings Full time

    Job Summary:We are looking for a skilled Nursing Pre-Approval Expert 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...


  • Pretoria, Gauteng, South Africa Qetello Holdings Full time

    Job Title: Junior Pre-Auth Healthcare Specialist Job Summary:We are seeking a talented and experienced Junior Pre-Auth Healthcare Specialist to join our team at Qetello Holdings. The ideal candidate will have a strong background in nursing and will be responsible for delivering cost-effective managed healthcare services primarily via email...


  • Pretoria, Gauteng, South Africa Qetello Holdings Full time

    Job OverviewIn this role, you will work as a Clinical Pre-Authorization Consultant at Qetello Holdings. As a key member of our team, you will be responsible for reviewing pre-authorisation applications and ensuring that they meet the required criteria.Key ResponsibilitiesApplication Review: Process and evaluate pre-authorisation applications to ensure...


  • Pretoria, Gauteng, South Africa Mirna Butler Recruitment Full time

    We are seeking a highly skilled Medical Receptionist to join our esteemed specialist medical practice in Pretoria-East.The ideal candidate will possess excellent interpersonal skills, be computer literate, and have experience in Practice Management.This is a fantastic opportunity for individuals who enjoy working in a dynamic healthcare environment.Key...


  • Pretoria, Gauteng, South Africa Beaver Immigration Consulting Full time

    Job DescriptionWe are seeking a highly skilled Medical Doctor to join our team at Beaver Immigration Consulting. The ideal candidate will have extensive experience in their specialty or as a general internal specialist, with a strong background in MBChB and a Masters of Medicine from a recognized South African medical school.The successful candidate will...

  • Medical Specialist

    1 month ago


    Pretoria, Gauteng, South Africa Mouldmed Locum International Exchange Full time

    Job DescriptionWe are seeking a skilled and experienced Medical Specialist to fill the role of ER Doctor. This is an exciting opportunity for a medical professional looking to join our dynamic team at Mouldmed Locum International Exchange.


  • Pretoria, Gauteng, South Africa Spesbilling Full time

    At Spesbilling, we are seeking a highly skilled and experienced Medical Claims Specialist to join our team. This is a challenging and rewarding role that requires a unique blend of medical billing expertise, technical skills, and communication abilities.Job SummaryWe are looking for a detail-oriented and organized individual with excellent coding experience...


  • Pretoria, Gauteng, South Africa Emporium Human Capital Full time

    Job OverviewEarn R700,750 per annum as a Medical Sales Specialist with Emporium Human Capital.We are seeking an experienced professional to join our team in Hatfield. This is an excellent opportunity for those passionate about Dermatology and sales performance.The ideal candidate will have a strong understanding of the therapeutic area and be able to build...


  • Pretoria, Gauteng, South Africa AJ Personnel Full time

    Job DescriptionWe are seeking a highly skilled Medical Laboratory Quality Assurance Specialist to join our team at AJ Personnel in Pretoria – Tshwane. This is an exciting opportunity for a qualified professional to work with us and make a significant impact on the quality of laboratory services.About the Job:The Medical Laboratory Quality Assurance...

  • Medical Professional

    2 weeks ago


    Pretoria, Gauteng, South Africa Beaver Immigration Consulting Full time

    Beaver Immigration ConsultingWe are seeking a highly skilled Medical Doctor to join our team in Canada. As a medical professional, you will have the opportunity to work with a supportive and collaborative environment, access cutting-edge medical technology, and receive relocation assistance.Key Responsibilities:Hold a MBChB and a Masters of Medicine in your...


  • Pretoria, Gauteng, South Africa MedE Recruit Full time

    MedE Recruit is seeking an experienced and highly skilled Eye Specialist Medical Assistant to join their esteemed team in Pretoria.This exciting opportunity offers a unique chance to work alongside leading eye care professionals, providing exceptional patient care and contributing to the success of the clinic.About the Role:Assist Eye Specialists in...


  • Pretoria, Gauteng, South Africa Gauteng Department of Health Full time

    Job OpportunityWe are seeking a highly skilled Medical Orthopaedic Specialist to join our team in Gauteng.Key ResponsibilitiesEvaluate and manage patients with Orthopaedic conditions in both inpatient and outpatient settings, conducting clinical assessments, diagnosing conditions, and developing treatment plans.Perform surgical procedures under supervision,...


  • Pretoria, Gauteng, South Africa Dis-Chem Pharmacies Full time

    Job Title:Clinical Support Specialist - Gauteng RegionAbout the Role:We are seeking a highly skilled and experienced Clinical Support Specialist to join our team at Dis-Chem Pharmacies in the Gauteng region. As a key member of our clinical support team, you will be responsible for providing exceptional patient care and support in our pharmacies.Key...


  • Pretoria, Gauteng, South Africa Emporium Human Capital Full time

    Job Summary:">We are seeking a highly skilled Medical Imaging Specialist to join our team at Emporium Human Capital.">About the Role:">This is a contract opportunity for an experienced Sonographer Diagnostic to work in Montana and Pretoria, offering a competitive salary of R 500 per hour (negotiable).">The ideal candidate will have a University degree in...

  • Medical Officer

    4 weeks ago


    Pretoria, Gauteng, South Africa Gauteng Department of Health Full time

    Job TitleMedical Officer - Gauteng General Medicine SpecialistAbout the RoleWe are seeking a highly skilled and dedicated Medical Officer to join our team in Gauteng, South Africa. As a Medical Officer, you will be responsible for providing high-quality patient care and management of general medical patients within the General Medicine Units at Helen Joseph...


  • Pretoria, Gauteng, South Africa Beaver Immigration Consulting Full time

    About the RoleWe are seeking a highly skilled Medical Imaging Specialist to join our team at Beaver Immigration Consulting.Job DescriptionThe successful candidate will be responsible for operating X-ray equipment, positioning patients and equipment to capture high-quality diagnostic images, and collaborating with radiologists and other healthcare...


  • Pretoria, Gauteng, South Africa Emporium Human Capital Full time

    Emporium Human Capital is currently seeking a highly skilled Diagnostic Medical Imaging Specialist to join our team in Montana. The ideal candidate will have a qualification/university degree in Radiology and/or Ultrasound, with HPCSA registration.The salary for this position is estimated at R380-R400 per hour, negotiable, and the working hours are 8 hours...

Medical Pre-Authorisation Specialist

2 months ago


Pretoria, Gauteng, South Africa Qetello Holdings Full time

Qetello Holdings is seeking a skilled Medical Pre-Authorisation Specialist to join our team in Pretoria. The ideal candidate will have a completed qualification as an Enrolled Nurse and be registered with SANC, with at least 2 years of experience in Managed Healthcare.

The successful candidate will be responsible for:

  • Receiving and attending to applications for services requiring pre-authorisation.
  • Capturing and verifying clinical information, including ICD-10 and item codes.
  • Validating and evaluating special pre-authorisation requests.
  • Preparing a summary of members' clinical history for the medical advisor.
  • Monitoring the flow of documents between the pre-authorisation division and the medical advisor.
  • Approving benefits accurately according to protocols.
  • Escalating identified risks to seniors.

Key qualifications include:

  • Grade 12
  • Completed qualification as an Enrolled Nurse
  • Registered with SANC
  • 2+ years of experience in Managed Healthcare
  • Good verbal and written English communication skills, as well as proficiency in understanding Afrikaans spoken and written communication.
  • Computer literacy in Ms Office.
  • Customer focus.
  • Ability to work in a team and handle conflict situations.
  • Comprehensive knowledge of the Medical Scheme Act.
  • Sound knowledge of CPT-4, ICD-10 and RPL codes.
  • Extensive clinical knowledge.
  • Exceptional work ethic.