Job Objectives:
To resolve medical aid rejection queries with member where medical aid has no impact e.g. benefit exceeded
To resolve medical aid rejection queries with medical scheme e.g. medication authorization
To provide member with status update regarding rejection and resolution thereof.
To resubmit all rejections within target set per medical aid i.e. between 40 and 60 queries per day to medical aid three days prior to due date of delivery
To resolve queries received from patients within a two hour turn-around time e.g. extended supplies due to member going oversees
Knowledge:
IT applications areas and delivery channels (Marconi, Phoenix and Exsol)
Current IT technology (6 months)
Medical Aid Formularies (6 months)
Product knowledge (1 year)
Pharmacy Council Legislation (1 year)
Minimum requirements
Education:
Essential
National Senior Certificate
Click Here To Apply