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Boutique Talent Partner in Finance. HR. IT. Management.

CURRENT JOB VACANCIES

Pre Authorization Consultant (RN) (5025 - CE)

Overview

Reference
5025 - CE

Salary
ZAR/month

Job Location
- South Africa -- Tshwane Metro -- Pretoria -- Arcadia

Job Type
Permanent

Posted
Monday, January 20, 2020

Closing date
27 Jan 2020 09:57


Our client based in Pretoria requires a Pre Authorization Consultant to join their team. 

Qualification & Experience Required: 

  • Degree/Diploma as a registered nurse and must be registered with SANC.
  • 2 Year’s relevant experience in a private hospital.
  • Comprehensive knowledge of the Medical Schemes Act.
  • Sound knowledge of CPT-4 & ICD-10 codes RPL.
  • Good communication skills in Afrikaans and English (read, write and speak).
  • Computer literate.

Core Duties & Responsibilities: 

  • Receive applications for all services which require pre authorisation.
  • Handling of telephonic authorisations, hospital, radiology and specialist referrals on the pre-authorisation call centre.
  • Capture clinical information and verify the information, including the applicable ICD-10 and item codes.
  • Confirm membership status & available benefits on the system before authorisation can be granted.
  • Validate and evaluate special pre-authorisation requests.
  • Ensure that the correct codes are used before benefits are approved.
  • Provide correct applicable information in respect of scheme rules, benefits & approvals in respect of all services requiring to patients and service providers.
  • Keep abreast of amendments to scheme rules, benefit options, legislation, protocols, processes and systems. 

Please note:

  1. Ensure you meet the minimum requirements as described above.
  2. We will only be getting back to applicants that meet all of the above requirements.
  3. Should you not receive a response from us within 2 weeks you can deem your application as unsuccessful for this specific position.

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ASIE Personnel 
www.asie.co.za


Contact information

Chandre Engelbrecht

cv@asie.co.za