SANC Nurse: Call Centre Pre-Auth Consultant

1 week ago

Centurion, Gauteng, South Africa Medpharm Recruitment Full time

A reputable Medical Aid Administrator is seeking Pre-Auth Consultants to join their Call Centre team, for an office-based role, in Centurion. (Salary R31K pm Cost to Company)

Duties:

  • Provide general clinical administrative support to the managed health care unit
  • Receive/reply to internal and external correspondence/queries from suppliers/service providers/clients/other employees as and when requested, using MS Word/MS Outlook/ in order to solve queries/problems in an efficient and effective manner.
  • Receive and respond to internal and external correspondence and queries
  • Ensuring successful & smooth Pre-Authorisation and Case Management process using telephone system
  • Ensure adherence to Scheme Rules on all Hospital Authorisations and clinical updates
  • Communicate decisions of the Clinical Committee to members/providers using MS Word/MS Outlook/template letters/telephone in order to inform
  • Typing communication to Service Providers and members
  • Generate and circulate reports on the system to ensure that outstanding authorisations and enquiries are followed up
  • Order/distribute stationary using stationary order forms in order for MHC personnel to have the necessary stationary to perform their tasks.
  • Compile Agendas for meetings eg. Clinical Committee
  • Arrange/schedule/invite/attend staff meetings/meeting venues/attendees using MS Outlook/MS Word in order to facilitate meetings/writing minutes of proceedings of meetings to record resolutions taken
  • Generate/collate/circulate reports on Medware using Outlook in order to ensure that outstanding authorisations and enquiries are followed up on by the Case Managers and Pre Auths.

Requirements:

  • Matric/Grade 12
  • SANC EN or RN
  • Computer Literate (MS Office / Internet / Email - Outlook)
  • Excellent Communication Skills
  • Available to work in office, on a daily basis, in Centurion

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