Clinical Consultants
4 hours ago
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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