Pre Auth Service Consultant - Inhouse

Discovery Limited; Milnerton; On-site; ZAR 150,000 - 210,000; Full time

Job summary

Discovery Limited - Discovery Health’s Inhouse Pre-Auth Service Consultant role focuses on delivering world-class service to Members, Providers, Employer groups, Hospitals and Brokers via telephone and other channels. You will manage benefit authorisations using clinical knowledge, ensuring accurate funding details and excellent customer experience.

The position requires knowledge of anatomy and physiology, strong communication, and the ability to adapt to changes while maintaining service

Qualifications

• Matric and SA accredited clinical qualification for minimum requirement.
• At least 6 months in customer services or clinical environment.
• Strong communication and digital tooling knowledge.

Responsibilities

• Deliver world class service to Inhouse scheme stakeholders via telephone and other channels.
• Confirm benefits and funding according to protocols and rules.
• Capture accurate information to confirm Inhouse scheme funding.
• Resolve queries and route to correct departments when needed.
• Maintain brand standards and service principles in every interaction.
• Stay updated with product changes and digital servicing tools.

Skills

Verbal communication

Written communication

Time management

Customer focus

Decision quality

Collaborating

Adaptability

Education

Matric

Clinical qualification (HR)

Tools

MS Office

Outlook

Job description

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Pre Auth Service Consultant - Inhouse

Business Unit: Discovery Health

Function: Call Center / Contact Center

Date: 21 May 2026

Key Purpose

To deliver world class service to all Inhouse scheme stakeholders (Members, Providers, Employer groups, Hospitals, and Brokers) by supporting and fully resolving their queries through various servicing channels, primarily over the telephone.

To effectively manage the risk of benefit authorisations (funding from risk) by using your clinical knowledge and integrating this with your understanding of the benefits of the scheme and ensuring accurate information regarding funding

Key outputs

The successful applicant will be responsible for but not limited to the following job functions:

• Confirming Inhouse scheme benefits according to set protocols and funding rules
• Accurately obtaining and capturing information to confirm correct Inhouse scheme funding
• Servicing all Inhouse scheme stakeholders telephonically and via other servicing channels until the query has been resolved
• stakeholders in a customer centric way to ensure that we live by our service principles
• Keeping up to date with product changes and benefits to ensure that all stakeholders are accurately serviced
• Continuously staying abreast of all digital servicing tools within the business and ensuring that the functionality is fully understood
• Achieving and exceeding key performance metrics relating to service delivery
• Keeping abreast of continuous process, product updates and digital tools
• Dealing with multiple interactions
• Consistently utilizing all servicing tools available
• Ensuring excellent quality service to all callers
• Identifying and reporting back on issues identified with systems
• Maintaining the brand as set out by the various schemes
• Routing all enquiries to correct departments, where applicable
• Assisting with CRM queries daily
• Must be willing to work overtime where necessary
• Attend additional training outside of working hours including weekends

Competencies and Skills

• Following instruction and procedures (Self-development)
• Analysing (Managing Complexity)
• Learning and Researching (Nimble Learning)
• Presenting and communicating information (Communicating effectively)
• Delivering results and meeting customer expectations (Customer focus)
• Deciding and initiating action (Decision Quality)
• Working with people (Collaborating)
• Writing and reporting (Communicating effectively)
• Clinical Knowledge
• Adapting and responding to change
• Persuading and influencing
• Adhering to principles and values
• Achieving personal work goals and setbacks

Knowledge

• Anatomy and Physiology

Skills

• Time Management
• Verbal and written communication
• Computer Literate with MS Office and Outlook skills

Personal Attribute and Skills:

• Customer Centric
• Knowledge of Anatomy and Physiology
• Time Management
• Living Discovery Values
• Discovery person traits
• Resilience

Education and Experience

Education:

• Matric
• South African accredited Clinical Qualification- HR to provide minimum requirement

Experience

• At least 6 months working experience in a customer services or clinical environment

EMPLOYMENT EQUITY

The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.