Pre Auth Service Consultant

Key Purpose

To deliver world class service to all Discovery Health Members, Providers, Employer groups, Hospitals, and Brokers by supporting and fully resolving their queries through various servicing channels, primarily over the telephone.

To effectively manage the risk of in-hospital admissions by using your clinical knowledge and integrating this with your understanding of the benefits of the scheme and ensuring accurate information regarding funding

Key outputs

The successful applicant will be responsible for but not limited to the following job functions:

• Confirming benefits according to set protocols and funding rules
• Accurately obtaining and capturing information to confirm correct funding
• Servicing all key stakeholders telephonically and via other servicing channels until the query has been resolved
• Servicing key stakeholders in a customer centric way to ensure that we live by our service principles
• Keeping up to date with product changes and benefits to ensure that all key stakeholders are accurately serviced
• Continuously staying abreast of all digital servicing tools within the business and ensuring that the functionality is fully understood
• Achieving and exceeding key performance metrics relating to service delivery
• Keeping abreast of continuous process, product updates and digital tools
• Dealing with multiple interactions
• Consistently utilizing all servicing tools available

Competencies and Skills

Behavioural Competencies

• Following instruction and procedures (Self-development)
• Analysing (Managing Complexity)
• Learning and Researching (Nimble Learning)
• Presenting and communicating information (Communicating effectively)
• Delivering results and meeting customer expectations (Customer focus)
• Deciding and initiating action (Decision Quality)
• Working with people (Collaborating)
• Writing and reporting (Communicating effectively)

Knowledge

• Anatomy and Physiology

Skills

• Time Management
• Verbal and written communication

Personal Attribute And Skills

• Customer Centric
• Knowledge of Anatomy and Physiology
• Time Management

Education and Experience

Education

• Matric
• South African accredited Clinical Qualification

Experience

• At least 6 months working experience in a customer services or clinical environment

EMPLOYMENT EQUITY

The Companys approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.