Pre - Authorisation
Edge Executive
- Johannesburg, Gauteng
- Permanent
- Full-time
3-5 years of Pre-Auth experience is required
Previous exposure to Renal Dialysis, Oncology, and/or Psychiatric environments would be highly preferred.
Exposure to Theatre and/or ICU in a private hospital is an added advantage
Sound knowledge of Coding Systems: and a deep understanding of the Medical Aid Industry, Rules & Regulations, ISO, and related legislation are necessary
Excellent business writing and communication skills, along with exceptional telephone etiquette, are essential
Must possess strong organisational awareness to anticipate the impact of actions on other groups
Time management and good administration skills are required.
Effective conflict resolution skills and the ability to work under pressure are necessary
Must be a strong team player and results-driven.
Computer literacy in MS Office and Medical Administration systems is requiredKEY RESPONSIBILITIES:
Ensure successful and smooth Pre-Authorization and case management processes telephonically in a call centre environment, via email, and online chat
Assist with Health Risk Management Monitoring and Management of hospital re-admissions
Compile and submit detailed reports to the Scheme on costs and patient progress