Clinical Hospital Pre-Authorisation Service Agent




Job Ref:


Date posted:

Tuesday, February 7, 2023


Port Elizabeth, South Africa



Our client in the Insurance Industry based in Port Elizabeth is currently looking to employ a Clinical Hospital Pre-Authorisation Service Agent.

An awesome career opportunity awaits!



  • Grade 12 Certificate – Essential.
  • Degree or Diploma in General Nursing – Essential.
  • Valid South African Nursing Council Registration – Essential.
  • MS Office Suite Experience – Essential.
  • 2 - 3 Years' experience in a private hospital – Essential.
  • Relevant experience in a call centre environment – Advantageous.
  • Exposure to claims and ICD-10 coding – Advantageous.
  • Understanding of the Medical Scheme Industry – Advantageous.



  • Pre-authorisation of all in-hospital procedures for applicable schemes, according to CRM protocols, telephonically and via email.
  • Pre-authorisation of all specialised radiology for all schemes, according to CRM protocols.
  • Pre-authorisation of all medical appliances and oxygen for all schemes.
  • Assistance with clinical related queries and escalations where applicable.
  • Presenting of complicated cases at clinical meetings when required.
  • Accurate and comprehensive recording of notes on the system.
  • Rotational filing of audit reports.
  • Running of daily reports and distribution to the applicable case managers.
  • Accurately resolve client queries and ensure excellent client service.
  • Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service.
  • Demonstrate exemplary team behaviour through personal involvement, commitment and dedication in support of organisational values.
  • Be part of a culture that directs best practice, fostering an environment of continuous learning, improvement and cohesiveness.
  • Identify own growth and development needs and discuss interventions to enable ongoing development, training and personal growth.
  • Deal with ambiguity, uncertainty and provide perspective in difficult situations.



Please note should you not receive a response within two weeks of applying please consider your application unsuccessful.



NB! This job is now closed. You can apply for other jobs by uploading your CV.




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