Pre Auth Service Consultant - Talent Pool

Discovery Limited; Gqeberha; On-site; ZAR 220,000 - 300,000; Full time

Job summary

Discovery Health is seeking a Pre-Authorization Service Consultant to provide world-class telephonic service to members, providers and brokers. You will assess benefits, confirm funding rules, and resolve queries while staying updated on product changes and digital tools.

A customer-centric approach and knowledge of Anatomy and Physiology are essential for success. The role requires a matric and a SA-accredited clinical qualification, with at least six months in a customer services or clinical

Qualifications

• Matric or equivalent qualification.
• South African accredited clinical qualification required.
• At least 6 months’ experience in customer services or clinical environment.
• Knowledge of Anatomy and Physiology.
• Strong time-management and communication skills.

Responsibilities

• Deliver world-class service to Discovery Health members, providers, employer groups, hospitals and brokers via telephone and other channels.
• Accurately assess and capture information to determine correct funding and benefits.
• Resolve queries and provide ongoing support until issues are closed.
• Maintain up-to-date knowledge of product changes, benefits and digital servicing tools.
• Operate with a customer-centric approach and meet service delivery metrics.

Skills

Time management

Verbal & written communication

Education

Matric

South African accredited Clinical Qualification

Job description

Discovery Health

PRE-AUTHORISATION SERVICE CONSULTANT

About Discovery

Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best. As global thought leaders, Discovery is passionate about innovating in order to not only achieve financial success, but to ignite positive and meaningful change within our society.

Key Purpose

To deliver world class service to all Discovery Health 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 in-hospital admissions 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

• Confirming benefits according to set protocols and funding rules
• Accurately obtaining and capturing information to confirm correct funding
• Servicing all key stakeholders telephonically and via other servicing channels until the query has been resolved
• Servicing key 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 key 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

Competencies And Skills

Behavioural Competencies

• 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)

Knowledge

• Anatomy and Physiology

Skills

• Time Management
• Verbal and written communication

Personal Attribute And Skills

• Customer Centric
• Knowledge of Anatomy and Physiology
• Time Management

Education and Experience

• Matric
• South African accredited Clinical Qualification

  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.