Hospital Pre-Authorisation Consultant – Telephonic Case Management

Pivot Services; Centurion; On-site; ZAR 250,000 - 350,000; Full time

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Job summary

Pivot Services in Centurion, Gauteng, South Africa, is looking for an analytical Pre-Authorisation Consultant within our Hospital Benefit Management group. The role leverages Clinical, Pre-Authorisation and Case Management experience to build effective relationships with members via telephony.

You will handle pre-authorisation and case management in a call centre setting, follow Scheme Rules, allocate facilities for members, address clinical queries, assist with health risk management and

Responsibilities

• Ensuring successful & smooth Pre-Authorisation and case management process telephonically in a call centre environment, on email and online chat.
• Ensure adherence to Scheme Rules on all Hospital Authorisations and clinical updates.
• Ensure correct allocation of facilities for our Members.
• Effective handling of Internal/External Clinical Queries Communicate with members and service providers to address hospital utilisation matters.
• Assist with Health Risk Management Monitoring & Management of hospital re-admissions.
• Compile & submit detailed reports to the Scheme on costs and patient’s progress.

Job description

Pivot Services in Centurion, Gauteng, South Africa, is looking for an analytical Pre-Authorisation Consultant within our Hospital Benefit Management group. The role leverages Clinical, Pre-Authorisation and Case Management experience to build effective relationships with members via telephony.

You will handle pre-authorisation and case management in a call centre setting, follow Scheme Rules, allocate facilities for members, address clinical queries, assist with health risk management and