Job Description

PLEASE NOTE THAT YOU MUST HAVE EXPERIENCE IN THE PHARMACEUTICAL INDUSTRY. ONLY APPLY IF YOU HAVE ALL THE NECESSARY EXPERIENCE.Grade 12.
Minimum 2 - 3 years experience in Administration.
Six months previous experience in customer service.
Computer literacy.
Knowledge of medical terminology is an added advantage.
Medical scheme experience is preferred.
Managed healthcare experience is preferred.Claim queries for Acute medication, Chronic medication, TTOs, Specialist medication, Casualty medication, Paper Claims from Pharmacies and Pathology claims.
Follow-up on outstanding chronic scripts.
ICD-10 codes in place with the necessary pathology results.
New membership medication queries.
Medication formulary queries.
Pharmacy deliveries on chronic disease management.
Sending of chronic registration letters to Providers, Members and Pharmacies.
Sending formulary lists to treating providers.
Ensure that condition baskets are loaded.
Contacting of treating providers, members and pharmacies to register members on programmes.
Copy notes from MIP system onto DMP system regarding medication approval.
Update provider details.
Update Pathology results.
Update member contact details on MIP system.
Upload documents onto the DMP system.
Membership queries on registrations, suspensions, exclusions and waiting periods.
Queries regarding change in treatment and / or add-on treatment
DUR on new registrations before sending to Mediscor.
ICD-10 codes in place with the necessary pathology results.Listening Skills.
Sensitivity and empathy.
Ability to cope with emotional situations.
Ability to relate to people.
Proficiency in English.
Strong telephonic and written communication skills.
Customer service orientation.
Patience and a calm manner.
Additional languages advantageous.
Results orientation.
High stress tolerance.
Following through on commitments.
Maintaining confidentiality of information.
Reporting skills.

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