Description:
Our client in the Insurance Industry based in Port Elizabeth is currently looking to employ a Clinical Hospital Pre-Authorisation Service Agent.
An awesome career opportunity awaits!
Requirements:
Grade 12 Certificate – Essential. Degree or Diploma in General Nursing – Essential. Valid South African Nursing Council Registration – Essential. MS Office Suite Experience – Essential. 2 - 3 Years' experience in a private hospital – Essential. Relevant experience in a call centre environment – Advantageous. Exposure to claims and ICD-10 coding – Advantageous. Understanding of the Medical Scheme Industry – Advantageous.
Responsibilities:
Pre-authorisation of all in-hospital procedures for applicable schemes, according to CRM protocols, telephonically and via email. Pre-authorisation of all specialised radiology for all schemes, according to CRM protocols. Pre-authorisation of all medical appliances and oxygen for all schemes. Assistance with clinical related queries and escalations where applicable. Presenting of complicated cases at clinical meetings when required. Accurate and comprehensive recording of notes on the system. Rotational filing of audit reports. Running of daily reports and distribution to the applicable case managers. Accurately resolve client queries and ensure excellent client service. Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service. Demonstrate exemplary team behaviour through personal involvement, commitment and dedication in support of organisational values. Be part of a culture that directs best practice, fostering an environment of continuous learning, improvement and cohesiveness. Identify own growth and development needs and discuss interventions to enable ongoing development, training and personal growth. Deal with ambiguity, uncertainty and provide perspective in difficult situations.
Please note should you not receive a response within two weeks of applying please consider your application unsuccessful.
07 Feb 2023;
from:
gumtree.co.za