Clinical Consultants

4 hours ago


Centurion, Gauteng, South Africa PPS Healthcare Administrators (PTY) Ltd (PPSHA) Full time R37 000 - R55 000 per year

We're looking for an analytical, detail-oriented Consultants
within the Hospital Benefit Management team
. The role involves managing telephonic hospital pre-authorisations, clinical queries, and case management while building strong relationships with our members.

Requirements:

  • Clinical Medical Associate qualification or Registered Nurse qualification
  • 1–2 years' Pre-Auth experience (Managed Healthcare)
  • Hospital exposure (Renal, Oncology, Psych, ICU or Theatre advantageous)
  • Strong knowledge of ICD-10, CPT-4, medical aid rules & healthcare legislation
  • Excellent communication, administration & time management skills
  • Computer literacy and ability to work under pressure

Key Responsibilities:

  • Telephonic/email/online pre-authorisations
  • Ensuring compliance with Scheme Rules
  • Handling clinical queries & hospital utilisation
  • Monitoring re-admissions & compiling reports


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