South Africa: Medical Aid Authorisations Administrator – Radiology posted by Emporium

Job Title:  Authorisations Administrator

Location:  Head Office – Alberton

Our Values: Customer Focused, Communication, Commitment, Continuous Improvement, Value our Colleagues and Ethical Behaviour.

Are you interested in…

Joining a dynamic team where you can make a real impact in patient care?
Diagnostic Radiological Services Inc. are looking for passionate, skilled professionals to join our fast-paced, supportive environment where teamwork and compassion are at the heart of everything we do.

We offer:

• Comprehensive onboarding and support.
• A collaborative environment and commitment to continuous team development through Arbinger training and principles.
• An opportunity to grow and expand your skills, constantly challenging yourself and advancing your career.
• A competitive salary package and benefits.

Your typical day in a radiology environment includes:

• Working closely with the rest of the team to provide superior diagnostic and interventional services.
• Collaborating with physicians and healthcare providers to ensure accurate, timely patient diagnoses.
• Managing patient care with compassion and professionalism, ensuring comfort and safety throughout their visit with us.
• Contributing to a fast-paced, evolving environment where your skills are valued and continuously honed.
   

Minimum Requirements:

• Grade 12 / Matric
• Course(s) in ICD-10 Coding
• 2 or more years’ experience in Authorisations in a Radiology environment  
• Basic knowledge of CT/MRI scans & anatomy
• Great attention to detail & ability to work under pressure
• Calm, approachable and patient disposition
• High level interpersonal skills and able to develop and maintain positive relationships with branches, hospital staff, patients and medical aids
• Some Short/On-line courses completed on self- development and soft skills e.g. effective communication, empathy, customer care, teamwork, conflict management, problems-solving, emotional intelligence, ethics, Outlook, Excel, Word etc. through providers such as Udemy.com and Alison.com
• Stable track record

Main Responsibilities:

• Correct patient details, dependent codes and ID numbers captured incorrectly.
• Ensuring referral letter, radiographer billing & radiologist report correspond.
• Analyse radiologist report and convert diagnosis into ICD-10 Coding.
• Ensure all claims are submitted accurately and timeously, with a high focus on both accuracy & speed.
• Action medical aid rejections & queries daily.
• Resolving queries as soon as possible.
• Any other duties that enable the smooth running and functioning of the billing & authorizations department.
• Assisting billing administrators with daily billing, if possible/necessary.
• Train new staff on authorisations and do refresher training with branch staff at regular intervals.
• Authorisation Administrator (CT/MRI’s):
• –         follow up daily on pending and rejected authorizations. 
• –         submit request forms and reports to medical schemes for PMB review on rejected or short paid claims.
• –         Follow up with branches regarding letters of motivation in order for the medical funds to review authorisations.
• Liaise with medical schemes to ensure correct benefits are applied, specifically:
• –         Oncology
• –         PMB
• Pull daily reports to ensure every examination is submitted correctly and the authorisation aligns with the report and billing.
• Print and scan all authorisation correspondence from medical funds
• Share knowledge and skills with your colleagues.
• Always remain calm and professional regardless of the circumstances.
• Take responsibility for a query and follow through to finalisation.
• Ensure you understand the POPI Act legislation, the protection of the disclosure of information of our patients / members and our own staff members and the impact thereof on our practice.
• Ensure you live the vision and values of the company:

Company Mission Statement: to be recognized as a leading world class radiology practice, providing high quality customer focused radiology services, efficiently and effectively.

Company Values: Customer Focused, Communication (professional, clear, empathetic, factual, active listening), Commitment, Continuous Improvement, Value (respect and appreciate) our Colleagues, Ethical Behaviour

• Perform other appropriate tasks and responsibilities assigned within the scope of your job function, knowledge, skills, and abilities.

Hours of Work:

•  Monday – Friday on a bi-weekly rotational basis:

            07:30 – 16:00 or 08:00 – 16:30

We encourage differently abled people to apply
We support an inclusive work environment and welcome applications from individuals with disabilities. A reasonable range of mobility is however essential in the medical field, including support staff. 

Why Choose Us?
At Diagnostic Radiological Services Inc, we focus on compassionate patient care and strong teamwork.

We offer a supportive, connected work environment that’s fast paced but less formal, with directors who are hands-on and closely involved with the team.

We have many long serving employees, celebrating 10, 15, 20, and a few 30 years of service.

We are proud to partner with the University of Johannesburg in training clinical staff and maintain an open-door policy, with a flat management structure.

We’re working to integrate Arbinger principles throughout our organisation, helping us cultivate a mindset of growth, collaboration, and mutual respect.

Ready to make a difference? Apply today to become part of a team that cares about your success and
well-being.