Our Client , A Respected Player In The Health Sector, Is Looking To Hire An Experienced And Efficient Authorization Clerk To Support Their Administrative And Clinical Teams. This Pivotal Role Involves Verifying Patients’ Medical Aid Coverage, Managing The End-To-End Authorisation Process For Medical Procedures, Prescriptions, And Ensuring That All Documentation Is Complete, Accurate, And Compliant With Medical Aid Policies. The Ideal Candidate Will Ensure That Required Approvals Are Obtained In a Timely Manner, And That All Relevant Information Is Clearly Communicated And Properly Recorded. In Addition To Maintaining Confidentiality And Data Integrity, The Successful Applicant Will Demonstrate Strong Organisational Skills, a Meticulous Eye For Detail, And The Ability To Manage Multiple Priorities In a High-Paced Environment. Previous Experience As a Medical Authorization Clerk Is Essential.
Role And Responsibilities:
- Obtain Authorisation From The Relevant Medical Aid Providers Before Rendering Any Services.
- Correctly Capture Required Data, Scan And Upload All Necessary Documents And Submit Claims Electronically Through The Standard Processes And Following Up On Missing/ Unscanned Documents.
- Ensure That All Shortfalls, Co-Payments Are Paid Or Followed Up Before Or As Soon As Services Are Rendered.
- Follow Up On Upfront And Outright Rejected Claims With The Members Or Patients.
- Attends To And Resolves Telephonic Queries Regarding Medical Aid/Clients Patients And Escalates Complicated Queries To HIs/Her Supervisor.
- Report Any System Driven Errors And Systems Setups That May Be Required To The Supervisor To Allow The Smooth Processing Of Claims And Payments.
- Ensure That All Provided Patient Data Is Clearly Legible And Accurately Matches The Details Submitted For Authorisation.
- Ensure That All Urgent Samples For Authorisation Will Not Delay Results By Following The Laid Down Procedures.
- Any Other Duties As Assigned By Management.