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Gauteng: Pre-Authorisation Consultant posted by Fusion Personnel

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Job Description

About the Role

We are seeking a highly skilled and experienced Pre-Authorisation Consultant to join our team at Fusion Personnel. As a key member of our healthcare solutions division, you will be responsible for authorizing hospital admissions, verifying in-hospital benefits and funding, and managing surgical and medical cases within defined cost limits.

Key Responsibilities

  • Authorize hospital admissions per scheme guidelines
  • Verify in-hospital benefits and funding
  • Manage surgical and medical cases within defined cost limits
  • Handle queries related to designated service providers, co-payments, and penalties
  • Refer complex and high-cost cases for further review
  • Maintain up-to-date knowledge of product changes and clinical guidelines
  • Achieve service delivery targets, including call center SLAs

Requirements

  • Nursing diploma (enrolled or registered nurse) or paramedic qualification
  • 3–5 years of experience in pre-authorization within managed healthcare
  • Knowledge of PMB conditions, clinical guidelines, ICD-10 codes, and hospital systems
  • Familiarity with medical scheme regulations and billing procedures

Qualifications

  • Nursing diploma (enrolled or registered nurse) or paramedic qualification

Salary & Benefits

(This section will be added automatically as part of the application process)

How to Apply

Click the green “Go Apply” button below to apply directly online with the employer.

About Other Medical Jobs in Gauteng

In Gauteng, the general job market trend for Other Medical positions is typically driven by an increasing demand for healthcare services, particularly in urban areas. This growth is often attributed to a growing population and an aging demographic, leading to a surge in medical tourism and specialized care needs.

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When it comes to salaries for Other Medical professionals in Gauteng, it’s essential to note that compensation can vary widely depending on factors such as experience, company size, and industry sector. Generally, salaries tend to be higher in larger organizations or those in high-demand sectors, but even within smaller companies, salaries can still be competitive. Typically, salaries range from R400 000 to R700 000 per annum, with more senior roles or those in specialized fields potentially falling outside of this range.

Common skills required for Other Medical positions in Gauteng often include a strong foundation in medical sciences, excellent communication and interpersonal skills, the ability to work effectively in a team environment, and proficiency in relevant software applications. Many professionals in this field also possess advanced degrees or certifications, which can enhance job prospects and career advancement opportunities. Additionally, the ability to remain calm under pressure, think critically, and make sound judgments is essential for success in this role.

In terms of industry sectors, Other Medical professionals are often employed in financial services, technology industries, manufacturing sectors, and healthcare organizations. These sectors frequently require specialized care or expertise, making them attractive employers for medical professionals. While specific companies may not always be publicly disclosed as major recruiters, larger multinational corporations like Google and Microsoft often have a presence in these industries.

Career development opportunities for Other Medical professionals in Gauteng are generally excellent, with many individuals progressing to senior roles within their current organization or transitioning into leadership positions within healthcare organizations. With experience, advanced degrees, or certifications, professionals can explore specialized fields like medical research, policy development, or medical education, which offer greater autonomy and professional fulfillment.

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This information provides general career guidance. Actual salaries and requirements vary by employer.



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