Clinical Hospital Pre-Authorisation Service Agent

Updated: March 09, 2024 12:29 PM GMT

Headhunters

Despatch, South Africa

Our client in the Insurance Industry based in Port Elizabeth is currently looking to employ a Clinical Hospital Pre-Authorisation Service Agent.

An awesome career opportunity awaits!

Requirements:
• Grade 12 Certificate – Essential.
• Degree or Diploma in General Nursing – Essential.
• Valid South African Nursing Council Registration – Essential.
• MS Office Suite Experience – Essential.
• 2 - 3 Years' experience in a private hospital – Essential.
• Relevant experience in a call centre environment – Advantageous.
• Exposure to claims and ICD-10 coding – Advantageous.
• Understanding of the Medical Scheme Industry – Advantageous.

Responsibilities:
• Pre-authorisation of all in-hospital procedures for applicable schemes, according to CRM protocols, telephonically and via email.
• Pre-authorisation of all specialised radiology for all schemes, according to CRM protocols.
• Pre-authorisation of all medical appliances and oxygen for all schemes.
• Assistance with clinical related... More Detail