Bring your possibility to life! Define your career with us
With over 100 years of rich history and strongly positioned as a local bank with regional and international expertise, a career with our family offers the opportunity to be part of this exciting growth journey, to reset our future and shape our destiny as a proudly African group.
Job Summary
Case management, handling all outpatient, inpatient, specialized services preauthorization, and Communicating with providers, clients and brokers on a timely basis
Job Description
- Manage 24 hour call centre
- Prompt response to emails, admissions requests.
- Critical analyzation of all medical requests from service providers.
- Efficient & accurate submission of approvals in line with the medical policy .
- Obtaining medical information from providers with written correspondence if necessary.
- Capacity to continually apply negotiation skills with the service providers
- Interacting with clients, Intermediaries and services providers as required to resolve problems in a manner that is legal, ethical and consistent with the principles of the policy.
- Accurate checking and confirming membership validity, benefits and sending member statement upon enquiry.
- Accurate guidance on provider network enquiries from brokers, providers, members etc.
- Vetting and confirming validity of the service given by the service provider in relation to the member benefit covered, treatment given, adherence to provider panel rules and cost of treatment
- Obtaining additional required information on invoice/claims from providers or clients.
Education
Further Education and Training Certificate (FETC): Business, Commerce and Management Studies (Required)
