A Managed Healthcare Company based in Centurion has vacancies available for Pre-Auth Consultants. The successful people need to start on the 21st of September.

To assist all clients telephonically for Pre-Auth .
Risk Management of in-hospital events and integration of scheme benefits with clinical knowledge to ensure accurate information regarding funding.
Managing inbound telephone queries and requests
Verify memberships
Accurately obtain and capture information to confirm correct funding
Ensure that the reason for admission is appropriate
Having an understanding of ICD, BHF and CPT codes
Capture comprehensive remarks on Paradigm and the in-house system
Confirm benefits according to set protocols and funding rules
Provide product information to all and in house members in line with the standards and protocols
Transfer calls not related to Pre Authorisation, to the relevant departments
Liaise with other internal departments to resolve queries on first contact
Resolving a query on the initial contact
Maintain confidentiality
Follow up on urgent queries and enquiries

Requirements
Strong clinical knowledge (Anatomy and Physiology)
Must be a qualified Enrolled Nurse or Ambulance Assistant
Must have excellent telephone skills
Must be Computer Literate