Pre-Auth Consultant

Afrocentric Group; Gauteng; On-site; ZAR 200 000 - 300 000; Full time

Job summary

A leading company in the Health and Human Services sector is seeking a dedicated professional for a multifaceted role in client service delivery and compliance. The ideal candidate will have nursing qualifications and experience in managed care operations. This entry-level position offers the opportunity to engage in various operational strategies and stakeholder management while contributing to departmental goals and continuous improvement.

Qualifications

• 1-2 years Managed Care Operations Experience.
• Registered in Nursing services, plus registration with SA Nursing Council.

Responsibilities

• Ensure exceptional service delivery and compliance with regulations.
• Contribute to departmental cost savings and operational performance.

Skills

Problem solving

Decision-making

Customer Care

Strong written communication

Strong verbal communication

Critical Thinking

Education

Registered in Nursing services

Tools

Microsoft Suite

Job description

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Location:

Johannesburg – Roodepoort

Job Classification:

Permanent

Remuneration Package:

Market Related

Join Our Talent Pool!

The AfroCentric Group is continuously on the lookout for individuals with expertise in the field indicated above.

As part of the ongoing efforts to streamline talent acquisition, we are seeking a motivated, talented, and diverse team to make a meaningful impact by submitting their applications.

Qualified candidates will undergo a fair screening process, including a Talent Pool Questionnaire and Pre-Employment Background Verifications.

Job Description

We are seeking a dedicated and detail-oriented professional to join our team in a multifaceted role that includes client service delivery, compliance and risk management, financial management, operational strategy implementation, leadership, and stakeholder management.

The successful candidate will follow established procedures and collaborate with peers and leaders to ensure exceptional service delivery.

They will maintain legal, statutory, and regulatory compliance, adhere to operational risk and governance standards, and proactively address issues.

Additionally, they will contribute to departmental cost savings to meet financial goals and targets.

The candidate will work with team members to meet delivery objectives, resolve operational performance issues, escalate unresolved problems, and ensure targets are met in a supportive manner.

Staying updated with operational changes, delivering quality standards, identifying opportunities for continuous improvement, and supporting transformation through valuing diversity are key aspects of the role.

The candidate will also deliver personal performance within Human Capital frameworks, engage in development, coaching, and mentoring, and maintain active relationships with customers and stakeholders, addressing complaints in line with policies to ensure buy-in.

Experience and Qualifications

• 1-2 years Managed Care Operations Experience
• 1-2 years Customer Servicing Experience
• 2-3 years General and Surgical Ward Experience
• 1-2 years Managed Health Care Experience (Call Centre) - Advantageous
• 1-2 years Trauma / ER Experience - Advantageous
• Registered in Nursing services, plus registration with SA Nursing Council

Knowledge

• Customer service operations
• Health legislation and regulatory standards
• Health Care Environment and Facilities

Skills

• Problem solving and decision-making
• Microsoft Suite
• Customer Care and Engagement
• Coping and resilience
• Strong written and verbal communication
• Administration and Numerical Ability
• Critical Thinking
• Ability to build trust
• Multi-Channel Communication

Additional Details

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Administrative, Customer Service, and Consulting
• Industries: Health and Human Services and Insurance