Pre-Authorisation Service Consultant

Staff Unlimited Recruitment; Gqeberha; On-site; ZAR 180,000 - 240,000; Full time

Job summary

Staff Unlimited Recruitment is seeking a Pre-Authorisation Service Consultant for a role in Gqeberha, South Africa. You will assist private healthcare clients telephonically by providing authorisation for cases already loaded and ensure queries and information follow established protocols.

Responsibilities include handling calls, maintaining pre-authorisation data, confirming scans, checking membership, and providing product information while upholding confidentiality.

Qualifications

• Must have knowledge of pre-authorisation processes and protocols.
• Healthcare/clinical background encouraged (Biochemistry or related fields).
• Proficiency with MS Word and Outlook is required.

Responsibilities

• Answer all telephone calls according to service standards.
• Transfer calls only when necessary.
• Maintain accurate pre-authorisation details in the system.
• Confirm scans according to prescribed protocols.
• Check membership validity.
• Ensure reason for admission is appropriate.

Skills

MS Word

Outlook

Education

Biochemistry

Human Movement Science

Registered clinical qualifications

Job description

Pre-Authorisation Service Consultant

My client in the financial services (private healthcare) industry is seeking a Pre-Authorisation Service Consultant to join their team in Gqeberha. The successful candidate will assist private healthcare clients telephonically by providing authorisation for cases that have already been loaded, while ensuring that all queries and pre-authorisation information are handled accurately and in accordance with established protocols and service standards.

KEY OUTPUTS & RESPONSIBILITIES

• Answer all telephone calls according to established service standards.

• Transfer calls only where no further assistance can be provided.

• Maintain accurate details of pre-authorisation information.

• Confirm scans according to prescribed protocols.

• Check the validity of membership.

• Ensure that the reason for admission is appropriate.

• Request BHF/ICD and CPT codes and motivation letters for pre-authorisation when necessary.

• Offer transfers to the Smart Health Choice Line to members requiring additional medical information regarding medical procedures and related matters.

• Follow up on urgent queries.

• Capture messages accurately on the system.

• Provide authorisation numbers for cases that have already been loaded.

• Provide product information to clients in line with call centre standards and protocols.

• Always maintain strict confidentiality.

MINIMUM REQUIREMENTS

• Candidates who have studied Biochemistry or Human Movement Science, with majors in Anatomy and Physiology, will also be considered.

• Candidates with a registered clinical qualification will be considered, for example:

  • Enrolled Nurse / Auxiliary Nurse

  • Paramedic

  • Radiologist

  • Occupational Therapist

  • Physiotherapist

  • Ambulance Assistant

  • Biokineticist

  • Or another relevant registered clinical qualification.

• Intermediate proficiency in MS Word and Outlook / Outlook Express.

ADVANTAGEOUS

• 6 months' call centre or customer service experience.

• Matric.

• Proficiency in English.