HUM Assessor - Parktown at Rand Mutual - RMA

WHAT WILL YOU DO?

• Generate the preauthorisation and feedback to Medical Service Provider (MSP) timeously
• Generate the hospital preauthorisation and feedback to MSP timeously
• Generate preauthorisation for Chronic medication for non-pensioners and supply feedback to MSP
• Authorise all Devices as per approval
• Ensure that all mandatory tariff codes are captured on authorisation
• Follow up on outstanding authorisation documents with Medical Service Providers
• Review and updating of ICD10 codes
• Preauthorisation of medical treatment in line with internal policies and Standard Operating Procedures
• Submission of daily, weekly, and monthly reports to Management
• Undertake relevant training as identified by line manager
• Adherence to Company Policies and Standard Operating Procedures
• Resolution of queries and complaints from stakeholders
• Participation in Company projects as and when requested
• Physio, Occupational Therapy and X-Rays
• Consultations, day procedures and corneal transplants
• Acute and chronic cases
• Assist with re-opening requests.
• Ad-hoc duties

WHAT YOU'LL BRING TO THE TABLE?  

• Diploma or Degree in Nursing or related field
• Minimum of 4 years nursing/medical aid environment experience
• Registration with nursing council and related
• Contributing to Team Success
• Decision Making
• Work Standards
• Applied Learning  
• Managing work and time management
• Stress tolerance
• Nursing Protocol
• Negotiation skills
• Communication skills
• Customer centric