Pre-Authorisation Consultants HBM
MVG Recruitment Specialists
- Undisclosed
- Permanent Intermediate position
-
Pretoria CBD
- Posted 23 May 2024 by MVG Recruitment Specialists
-
Job 2568247 - Ref LM/PreHBM
About the position
Our client, in Managed Care, seeks to employ an Enrolled Nurse for the accurate issuing of appropriate Pre-Authorisations that meets the requirements of clinical appropriateness. The role is performed in a contact centre.
Key requirements:
- Enrolled Nurse with SANC.
- Minimum of 5 years experience as a nursing practitioner (ICU/ theatre experience).
- 1 year experience gained in the medical funding industry (essential).
- Medical Scheme-related experience in Hospital Benefits Management required.
Key responsibilities:
- Delivering cost-effective managed healthcare services to accomplish member satisfaction.
- Deliver an effective call centre service in order to achieve member satisfaction.
- Reduce the risk associated with hospital and authorised cases.
- Telephone etiquette, Answering calls in a way that achieves member satisfaction.
- Verifying prosthesis limits, to contain costs for both members and fund.
- Evaluating treatment, LOS and LOC.
- Knowledge of current coding systems (ICD10's, CPT4, NRLP, and HBM conditions).
To apply, email copies of your supporting documents together with your CV to response "at" [URL Removed] or call us on [Phone Number Removed];.
Supporting documents required:
- Copy of SANC receipt
- Copy of ID
- Copy of latest pay slip
- Copy of qualification(s) and Matric
Desired Skills:
- 1 year experience gained in the medical funding industry (essential).
Desired Qualification Level & Accreditations:
- Diploma
- South African Nursing Council
MVG Recruitment Specialists
About the agency
Headquartered in Cape Town.
Medical and Pharmaceutical Recruitment Specialists; Specialising in the placement of pharmacists, pharmacist assistants, nurses and technical staff into all areas of the medical/pharmaceutical industry nationally in South Africa. APSO Registered.
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