Service Provider Consultant - Medical Aid
Pretoria, R25 000 - R27 500 ctc Per Month
Benefits: Medical Aid, Pension, Parking
NQF Level 5 (e.g. National Certificate in Administration). Degree/ Diploma in Adminstration/ Business AdministrationSectors: Admin, Business Management, Medical
We are looking for a Service Provider Consultant for the managed healthcare sector with relevant experience.

dedicated Provider Consultant Service
Lengthy and complicated Service Provider/ Member enquiries handled, logged and referred to relevant department where applicable – telephonically & electronically & walk-in
Sourcing and receiving contracts by e-mail, snail mail or hand
Processing, printing, scanning and loading of contracts on IT System
Loading contracts to system
Confirm receipt of service provider contracts in writing
Monitor Provider claims as per contracts (policing of network behaviour) – outcomes dependant on quality data received weekly
Quality Assurance of Provider claims as per contract Assist in processes for claims and authorisations for Network Providers. Liaise with departments within regarding claims and authorisations for Network Providers. Participate in tariff changes. Participate in annual tariff increases