Pre-Authorisation Consultant
Posted on 2025-03-03
| Salary | 420000 Annually |
|---|---|
| Category | Healthcare Nursing |
| Location | Gauteng / Johannesburg |
Job Summary
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. 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, Johannesburg. This job position was posted by . The job has been posted on 2025-03-03 in the Healthcare Nursing category
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