Preauthorisation Nurse - Benoni

Our preauthorisation department in Benoni is looking for qualified nurses fluent in Afrikaans (non negotiable) with preauthorisations experience to assess the authenticity and legitimacy of requests for medical services or treatment by members or service providers in a timely, effective, efficient, equitable and client centred manner. 1. Key Tasks (By KPA for clarity) Authorise or Decline Medical Services or Treatment Validate membership status and available benefits based on plan type Confirm that all necessary information is provided to support the request Determine if the requested medical services or treatment are medically necessary and align with the member's health needs Evaluate the risk of harm to the member if the requested medical services or treatment are not approved Ensure that all decisions are made in a fair, transparent and consistent manner. The ideal candidate will have the following skills and experience: Strong clinical knowledge and understanding of preauthorisation processes Ability to work independently and as part of a team Excellent communication and interpersonal skills Ability to manage multiple tasks and priorities effectively Ability to maintain confidentiality and handle sensitive information with discretion