Call Center Nurse at Old Mutual South Africa

Job Description

• To resolve customer queries over the phone and offer solutions to the customers in a timely manner
• Supervise Pre-authorization of scheduled and non-scheduled admissions within the set guidelines and carry out verification and medical Audit of claims/invoices before settlement.
• Managing requests for services from providers, intermediaries and clients, providing information on the UAP Old Mutual provider network and available benefits per scheme policy
• In conjunction with SMART applications resolve card issues raised at the point of service
• Authorization of all optical requests from the different providers within 6 hours and prepare daily reports
• To attend to reimbursements from the different providers in a timely manner and provide daily reports.
• Liaise with other medical schemes for purposes of evaluating medical risk.
• To formulate committal letters of discharges as a result of the requests from the different service providers

Responsibilities

Skills and Experience

1 – 2 Years experience in a similar role

Education

Diploma (Dipl.): Nursing

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