Career

Authorisations Manager

Authorisations Manager

Introduction

Provide leadership and operational management of the Authorisations Team, to ensure accurate and timely pre-authorisation and feeing of specialised CT and MRI procedures. The Authorisations Manager will drive performance through monitoring, support and alignment of key objectives. The role requires siginificant analytical input and application through Excel and BI systems, the ability to lead discussions and influence decision making across various departments, along with a solid understanding of basic accounting principles. The Authorisations Manager will work closely with the Financial Controller to support initiatives and drive performance also in other Departments including the Debtors Function.

Duties & Responsibilities

  • – Demonstrate specialist knowledge of medical aid benefit structures, plan exclusions and standard copayments through research, reading scheme published material and liaising with key stakeholders
  • – Daily monitoring of authorisation and feeing lists to ensure targets are met
  • – Regular spot check to ensure accuracy and compliance, to measure processing times and to support any performance related discussions
  • – Analysis and discussion alongside clinical coding to improve accuracy and reduce rejection rates
  • – Complaints handling – document and liase with relevant stakeholders to resolve any authorisation related disputes
  • – Conduct site visits to build strategic relationships with branch staff and to improve patient experience
  • – Regular review to ensure that the team receives the necessary training
  • – Develop and maintain the various workflows around pre-authorisation, follow up and feeing
  • – Manage all aspects of team attendance and performance, and ensure company policy is understood and applied
  • – Maintain a high level of client focus when assisting patients, colleagues and clinicians
  • – Change champion – continuously support and participate in improvement initiatives

Desired Experience & Qualification

  • – Matric certificate and relevant degree ( degree in Administration, Finance and or Accounting will be Preferred)
  • – Medical terminology and/ or clinical coding experience and qualification will be advantageous.
  • – Must have 2-3 years team leading experience and 3-5 years medical industry within patient administration and Authorisations.
  • – Excellent interpersonal, problem solving and communication skills.
  • – Computer literacy including Microsoft Excel
  • – Proven track record managing high output teams
  • – Exposure to Medical terminology and medical aid tariff structures (preferred)
  • – Excellent time management and multitasking skills
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