AUTHORISATIONS CLERK

The main purpose of this role is pre-authorising specialised CT and MRI procedures to reduce financial risk for the company, the authorisations clerk will understand different scheme rules and advise patients of any shortfalls, co-payments, and scheme exclusions.  * Obtain pre-authorisation and or confirm benefits for specialised CT and MRI examinations through the use of specialised software and/ or telephone calls to the various medical aid schemes. * Apply medical terminology knowledge to properly assess the requirements of referring clinicians. * Obtain correct ICD10 diagnosis codes and tariff codes for the purpose of accurate pre-authorisations. Escalate concerns and request additional information where required. * Ensure a high standard of documentation and capture of relevant information which is essential for branch staff to understand next steps. * Inform patients of co-payments or non-payment by medical aid timeously and prior to their examinations. * Assist branch staff with ad hoc and also last minute bookings. * Contact clinicians or their secretaries when motivation letters are required. * Update and validate patient examinations after confirming that all details and codes are correct. It is essential to follow the established validation checklist and products guideline when performing this task. * Responsible for following up and completing any outstanding validations for your designated branches * Establish whether PMB consideration may be advised on cases where authorisation was declined or shortfalls exist. * Maintain a high level of client focus when assisting patients, colleagues and clinicians. * Excellent interpersonal and communication skills. * Computer literacy. * Ability to work as part of a team. * Commitment to high quality standards. * Proven experience in multitasking * ICD10 diagnosis codes and medical terminology knowledge (preferred) * Proven experience working with multiple software packages – incl MS Office suite * Demonstrated call handling experience / skills * Excellent time management skills.  * Matric certificate. * Computer literacy. * Medical terminology and/ or clinical coding certificate * Basic Salary * 13th Cheque * 22 working days leave * Medical Aid * Pension Fund * Group Life & Disability Benefit * Funeral Benefit * Uniform * Excellent interpersonal and communication skills. * Computer literacy. * Ability to work as part of a team. * Commitment to high quality standards. * Proven experience in multitasking * ICD10 diagnosis codes and medical terminology knowledge (preferred) * Proven experience working with multiple software packages – incl MS Office suite * Demonstrated call handling experience / skills * Excellent time management skills.  * Matric certificate. * Computer literacy. * Medical terminology and/ or clinical coding certificate