Pre-Authorisation Consultant - Healthcare Case Management

Pps; Gauteng; On-site; ZAR 350 000 - 500 000; Full time

Job summary

A leading healthcare company in Gauteng is seeking a Pre-Authorisation Consultant to manage hospital authorisations and clinical updates. The ideal candidate should have a nursing qualification and substantial experience in managed healthcare, particularly in high-pressure environments. Strong communication skills and analytical abilities are essential. This permanent role offers the chance to make impactful decisions in patient care management.

Qualifications

• 10 years Pre-Auth experience if no clinical qualification.
• Previous exposure in a Managed Healthcare Call Centre.
• Sound knowledge of ICD10 & CPT4 Principles.

Responsibilities

• Ensuring successful Pre-Authorisation process telephonically.
• Ensure adherence to Scheme Rules on Hospital Authorisations.
• Compile & submit detailed reports to the Scheme.

Skills

Analytical skills

Attention to detail

Communication skills

Conflict resolution skills

Team player

Computer literacy (MS Office)

Education

Nursing qualification

Emergency Services qualification

Tools

Medical Administration system

Job description

A leading healthcare company in Gauteng is seeking a Pre-Authorisation Consultant to manage hospital authorisations and clinical updates. The ideal candidate should have a nursing qualification and substantial experience in managed healthcare, particularly in high-pressure environments. Strong communication skills and analytical abilities are essential. This permanent role offers the chance to make impactful decisions in patient care management.