Job Purpose
The position involves pre-authorization of in – patient procedures balancing aggressive cost containment with optimal customer service. The applicant must be able to maintain effective and collaborative relationships with hospitals/physicians whilst being conscious of relationships with brokers, clients and policy holders.
Key Responsibilities
Preauthorization of in-patient treatment.
Aggressive cost containment through tight adjudication, correct evaluation of medical appropriateness and successful negotiation.
Case management of complex cases.
Maintain relationships with brokers/clients/providers.
Medical claims reviews
In line with plans to provide 24 /7 service to our insured members this role may involve working night and weekends on a rotational basis.
Experience Required
• Minimum of 1 years professional clinical experience in a multi-practice operation or hospital.
• Must be Fluent in English and French.
For further information please call Linda at 01 2784671 or email your CV in the strictest confidence to ldunne@thornshaw.com .
