Pre Auth Service Consultant - Vitality Health - Talent Pool

Discovery; Gqeberha; On-site; ZAR 300,000 - 400,000; Full time

Job summary

A leading healthcare provider in Gqeberha is looking for a Pre-authorisation Service Consultant to deliver excellent service to members and health providers. The role involves confirming benefits, managing queries, and supporting stakeholders through various channels. Candidates should have a Matric, a clinical qualification, and experience in customer service. Join a dynamic team committed to health and service excellence.

Qualifications

• At least 6 months working experience in a customer services or clinical environment.
• Deep understanding of Anatomy and Physiology.

Responsibilities

• Deliver world class service to all Discovery Health Members and Providers.
• Manage risk of in-hospital admissions with clinical knowledge.
• Confirm benefits according to set protocols and funding rules.
• Resolve queries through various servicing channels.

Skills

Time Management

Verbal and written communication

Working under pressure

Education

Matric

South African accredited Clinical Qualification

Job description

Overview

Discovery Health

Pre-authorisation Service Consultant – Vitality Health

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.

What is a Talent Pool?

In simplest terms, a talent pool is a database of candidates that have already been deemed qualified for particular positions and who can be offered roles as soon as they become available.

What does this mean for you?

It’s good news because it means, you will still go through the recruitment process (assessments, role plays and interviews) and if you meet our minimum criteria, will be next in line for consideration as soon as we require more staff.

You will remain as an active candidate on our database and we will update you on progress on a monthly basis.

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

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

• 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
• Working under pressure

Personal Attribute and Skills

• Customer Centric
• Able to work during international business hours (UK Time zone)

Education and Experience

Education:

• 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.