with our valued client to seek a Clinical Pre-Authorisation Consultant. We are looking for an ideal candidate
with our valued client to seek a Clinical Pre-Authorisation Consultant. We are looking for an ideal candidate
Consultant (Pre-Authorisations) involves ensuring that healthcare services requiring pre-authorisation are evaluated protocols and funding guidelines. Loading of authorisations and the application of standard predictable funding guidelines across all services and authorisation categories. Clinical Risk Management to reduce the risks associated with hospitals and other authorised services. Establish the presence of any co-morbid well-grounded clinical knowledge of the pre-authorisation of hospital admissions (including Length of
Medical aids. Code all patients Assist with final authorisation of patient files. Control costs for patients medical aid tariffs, as well as medical aids authorisation processes EN and registration with SA Knowledge Knowledge of high-cost medication authorisation procedures 3 years hosptial or medical faclility case management
Medical aids. Code all patients Assist with final authorisation of patient files. Control costs for patients medical aid tariffs, as well as medical aids authorisation processes EN and registration with SA Knowledge Knowledge of high-cost medication authorisation procedures 3 years hosptial or medical faclility case management
check section 14 claims Claim authorisation (Banking 1st or 2nd authorisation payments) Claim management (Including supervisor invoice review) Validation and authorisation of month end processes (cash outflows) Processing Management Transaction review, validation and authorisation Compile, intervene and report on portfolio Validation Validation, tracking and authorisation of section 14s in and out Provide intervention and technical resolution
check section 14 claims Claim authorisation (Banking 1st or 2nd authorisation payments) Claim management (Including supervisor invoice review) Validation and authorisation of month end processes (cash outflows) Processing Management Transaction review, validation and authorisation Compile, intervene and report on portfolio Validation Validation, tracking and authorisation of section 14s in and out Provide intervention and technical resolution
protocols and funding guidelines. ● Loading of authorisations and the application of standard predictable funding guidelines across all services and authorisation categories. ● Clinical Risk Management to reduce well-grounded clinical knowledge of the pre-authorisation of hospital admissions (including Length of and other healthcare services requiring pre-authorisation ● Excellent telephonic and written communication
programs that promote best practices in pre-authorisation processes. DUTIES & RESPONSIBILITIES: Quality and Monitoring: Conduct regular audits of pre-authorisation cases to ensure compliance with clinical guidelines Compliance and Documentation: Ensure that all pre-authorisation activities comply with relevant regulations
Assurance Coach Reporting to: Team Leader: Pre-Authorisations Location: Head Office, Pretoria Contract Type: programs that promote best practices in pre-authorisation processes. DUTIES & RESPONSIBILITIES: Quality and Monitoring: Conduct regular audits of pre-authorisation cases to ensure compliance with clinical guidelines