Preauthorization Administrator

Introduction Through our client-facing brands Momentum Group, with Multiply (wellness and rewards programme), and our other specialist brands, including Guardrisk and Eris Property Group, the group enables business and people from all walks of life to achieve their financial goals and life aspirations. We help people grow their savings, protect what matters to them and invest for the future. We help companies and organisations care for and reward their employees and members.

Disclaimer As an applicant, please verify the legitimacy of this job advert on our company career page.

Role Purpose To efficiently review, process, and manage dental pre-authorisation requests within service level agreements (SLAs) and according to company policies and regulatory requirements. The primary focus is on accurately assessing and capturing pre-authorisations from multiple platforms, ensuring compliance with clinical protocols and scheme rules, while supporting timely and appropriate member care.

Requirements****Qualification

• Matric Certificate (Essential).

• Relevant tertiary qualification – Dental Assisting, healthcare administration or equivalent.

Experience

• Minimum 2 years’ experience in dental administration.

• Prior experience in medical aid benefits, billing, and claims processing.

• 1–3 years’ experience in Managed Care Operations or Pre-Authorisation.

• Strong understanding of medical scheme protocols and benefit structures

Duties & Responsibilities* Accurate and timely capture and assessment of dental pre-authorisation requests.

• Effective resolution and reporting of system issues.
• Completion and documentation of pre-authorisation batches.
• Clear communication of assessment outcomes to stakeholders.
• Identification of potential clinical or fraud risks based on request trends.
• Consistent achievement of productivity and quality standards.

Competencies* Strong attention to detail and accuracy.

• Good organizational and time management skills.
• Ability to navigate and utilize multiple digital platforms.
• Clear and professional communication skills.
• Sound understanding of dental clinical protocols and scheme rules.
• Analytical mindset to identify trends and risks.