PRE-AUTHORISATION CONSULTANT: HBM

Bestmed Medical Scheme • Other • Other (Gauteng, South Africa) • $300 - $400 / year • 20h ago

Bestmed Medical Scheme Job Description

Bestmed is a non-profit, mutual medical scheme registered with the Council for Medical Schemes. We have been providing healthcare to the lives of South Africans for over 60 years.

Bestmed strives to be an employer of choice by:

Creating a Personally Ours culture where we can all contribute in our unique way to make Bestmed the best employer for our Talent.
Creating an environment that optimises individuals to contribute their best version of themselves.
Promoting a highly engaged workforce in a performance enabling environment where employees are valued and rewarded for their commitment and dedication.

Bestmed offers an exceptional benefit programme and competitive packages, including 23 days annual leave and a workday of only 8 hours, including a 30-minute break. Permanent employees have the options of life cover, disability benefits, funeral cover, pension fund, medical aid and more. Access to development opportunities are plentiful. Office benefits include free parking, free Wi-Fi, landline phone allowance, and free refreshments. Bestmed Heartbeats also have access to fitness facilities and running clubs such as an on-site gym, the Bestmed Athletics Club, Pilates and the Tempo Wellness Programme (T&C apply). Many team interactions, recognition programmes and incentives make your support structure one with lots of fun, laughter and something to strive towards. We celebrate your successes, endurances and life events with you. We constantly strive to innovate for you and by you.

If you are willing to lead the way, go the extra mile, do the right thing, be upbeat and play for the team…you may be the perfect candidate to join a journey that is Personally Yours with Bestmed!

We are committed to ensuring that all employees have opportunities for professional development, as well as fair compensation and employee benefits. We are also committed to ensuring a congenial and collegial work environment, where innovation is welcomed and encouraged. As such, we reinforce a culture of zero tolerance towards any forms of inappropriate behaviour, abuse (including abuse of power, privilege or trust), harassment, or exploitation of any kind to safeguard our members, employees and partners. This is our top priority and we take our responsibilities extremely seriously. All employees are required to share in this commitment through our Code of Conduct.

Bestmed is an equal opportunity, disability-confident employer and we are committed to achieving the highest standards of diversity, fairness and equality. We conduct the most appropriate pre-employment assessments and verification checks to ensure that high standards are maintained. Should you have a disability and require any additional support, please contact us at

Bestmed reserves the right to schedule and cancel assessments and interviews. Bestmed also reserves the right not to make a placement.

Duties & Responsibilities

Delivering cost-effective managed healthcare services to accomplish member satisfaction.
Client Relations: To assist the client by approving appropriate funding.
To deliver an effective call centre service in order to achieve member satisfaction.
Risk Management: To reduce the risk associated with hospital and authorized cases.
Telephone Etiquette: Answering telephone calls in a way that achieves member satisfaction.
Verifying prosthesis limits: To contain costs for both members and fund.
On-going training and development: To update knowledge and skills in order to deliver a cost-effective and professional service.
The actual benefit expenditure per beneficiary per month for hospitalization should be less than the budget benefit expenditure. Pre-authorization should be granted within the option benefits, Scheme and clinical protocols.
Effective Customer Service Delivery: To deliver an effective call centre service in order to achieve member satisfaction.
Delivering a cost-effective Managed Healthcare service: To deliver affordable Managed Healthcare services.