Care Manager-Nurse-2 First Assurance Job at Absa Bank Limited

• Manage 24 hour call centre
• Prompt response to emails, admissions requests.
• Critical analyzation of all medical requests from service providers.
• Efficient & accurate submission of approvals in line with the medical policy .
• Obtaining medical information from providers with written correspondence if necessary.
• Capacity to continually apply negotiation skills with the service providers
• Interacting with clients, Intermediaries and services providers as required to resolve problems in a manner that is legal, ethical and consistent with the principles of the policy.
• Accurate checking and confirming membership validity, benefits and sending member statement upon enquiry.
• Accurate guidance on provider network enquiries from brokers, providers, members etc.
• Vetting and confirming validity of the service given by the service provider in relation to the member benefit covered, treatment given, adherence to provider panel rules and cost of treatment
• Obtaining additional required information on invoice/claims from providers or clients.

Education

• Further Education and Training Certificate (FETC): Business, Commerce and Management Studies (Required)