Pre authourize nurse
SCP SECURITY SERVICES
Benoni, Gauteng
This listing does not state a salary. As a guide, nursing roles in South Africa typically pay R14 000 to R40 000 a month (indicative).
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Nursing and care roles are in constant demand across SA hospitals, clinics and care homes, from caregivers to registered professional nurses.
Job description
Pre-Authorisation Nurse
Company: Affinity Life Limited
Location: Benoni
Department: Pre-Authorisation
About the Role
Affinity Life Limited is looking for a professional and detail-oriented Registered Nurse to join our Pre-Authorisation team.
The successful candidate will assess and process medical pre-authorisation requests, ensuring that services are approved or declined in line with applicable benefits, clinical guidelines, policies and protocols.
Key Responsibilities
- Assess and process pre-authorisation requests for medical services and treatment.
- Validate membership, benefits, waiting periods and policy exclusions.
- Approve or decline requests in accordance with clinical guidelines and protocols.
- Assess requests for hospitalisation, specialist visits, diagnostics, emergency and other medical services.
- Identify and mitigate potential waste, abuse and inappropriate utilisation of benefits.
- Request and review supporting medical documentation where required.
- Provide members and healthcare providers with pre-authorisation outcomes.
- Handle escalations, appeals and queries.
- Maintain accurate records and adhere to company policies, regulatory requirements and SLA turnaround times.
Requirements
- Matric.
- Diploma or Degree in Nursing.
- Registered Nurse (SANC registered).
- Minimum 2 years’ clinical nursing experience.
- Managed care/pre-authorisation experience will be advantageous.
- Knowledge of medical aid benefits and clinical coding.
- Working knowledge of ICD, BHF and CPT codes**.**
- Theatre and Trauma experience
- Computer literate with good administrative skills Key Attributes
Professional Detail-oriented Accountable Honest Flexible Hardworking
Interested candidates are invited to submit their CV to sithembile.rantai@affinityhealth.co.za
Applicants will be selected according to the vacancy criteria.
Work Location: In person
Found on Indeed · Posted 1 months ago · Last checked 2 weeks ago
Good to know
What does this nursing job pay?
This listing does not state a salary. As a guide, nursing roles in South Africa typically pay R14 000 to R40 000 a month (indicative).
Do I need experience for nursing jobs in Benoni?
This nursing role may ask for some experience or a relevant qualification. Read the listing for the specifics before you apply.
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Found on Indeed · Posted 1 months ago
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