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.
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.
Pre-Authorisation Consultant position available in Gauteng, Gauteng. This job position was posted by Fusion Personnel. The job has been posted as a char8000 ad on 2025-02-21 at 01:00:57 in the Medical category
Click Go Apply to apply online!
You might also like these jobs in the same area.
Apply directly for this position. Please read all instructions carefully.
We do not process job applications; we simply aggregate and display job listings.
More related positions
Pretoria: Clinical Pre-Authorisation Consultant posted by Qetello
Our client is seeking a Clinical Pre-Authorisation Consultant to join their dynamic team. If you`re a healthcare professional registered with the South African Nursing Council (SANC) as a Registered Nurse, with at least two years of experience in Managed H
View Job
Clinical Pre-Authorisation Consultant
Pretoria: Medical Pre-Authorisation Consultant (Enrolled Nurse) posted by Qetello
Together with our client in Pretoria, we are recruiting for a Medical Pre-Authorisation Consultant. The ideal candidate must have a completed qualification as an Enrolled Nurse and must be registered with SANC, with at least 2 years experience in Managed H
View Job
Medical Pre-Authorisation Consultant (Enrolled Nurse)
Pretoria: Medical Pre-Authorisation Consultant (Enrolled Nurse) posted by Qetello
Together with our client in Pretoria, we are recruiting for a Medical Pre-Authorisation Consultant. The ideal candidate must have a completed qualification as an Enrolled Nurse and must be registered with SANC, with at least 2 years experience in Managed H
View Job
Medical Pre-Authorisation Consultant (Enrolled Nurse)
Johannesburg: Pre-Authorisation Consultant
Requirements: Nursing diploma (enrolled or registered nurse) or paramedic qualification. 35 years of experience in pre-authorization within managed healthcare. Knowledge of PMB conditions, clinical guidelines, ICD-10 codes, and hospital systems. Familiarit
View Job
Pre-Authorisation Consultant
Gauteng: Pre-Authorisation Consultant posted by Fusion Personnel
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.Familia
View Job
Pre-Authorisation Consultant