Thando Hanise Email & Phone Number

Johannesburg, Gp, Za

Johannesburg Metropolitan Area

South Africa

Pre-Authorization Management: Facilitated the timely processing of pre-authorization requests for medical procedures and treatments, ensuring adherence to company policies and regulatory guidelines.Communication and Coordination: Effectively liaised between healthcare providers, policyholders, and internal departments to gather necessary information and expedite pre-authorization decisions.Clinical Review: Conducted thorough assessments of medical documentation to evaluate the medical necessity and appropriateness of requested procedures, treatments, and services.Policy Adherence: Ensured compliance with insurance policies and procedures while evaluating pre-authorization requests, balancing patient needs with cost containment measures.Quality Assurance: Implemented quality assurance measures to maintain accuracy and consistency in pre-authorization decisions, contributing to improved operational efficiency and customer satisfaction.Documentation and Reporting: Maintained detailed records of pre-authorization requests, decisions, and communications, generating comprehensive reports to track performance metrics and identify areas for process improvement.Billing Coordination: Engaged proactively with billing departments to streamline the invoicing process, ensuring transparent communication with policyholders and healthcare providers to resolve billing queries promptly and maintain positive relationships.Customer Grievance Handling: Employed active listening and empathy to address policyholder complaints regarding pre-authorization decisions, swiftly resolving issues to foster trust and loyalty, while also providing feedback to internal teams for process refinement and continuous improvement.

Port Elizabeth Metropolitan Area

• Responsible for the mental well-being and rendering of physical health care, through medication and health assessments while supporting the multidisciplinary team in the monitoring and necessary interventions for optimum healthcare offering. • By identifying clients care requirements and establishing a healthy personal rapport.• Undertaking treatment options and carrying out appropriate procedures and clinical interventionsincluding counselling, advising and provision of information through on-going health education.• Assessing urgency and severity of presenting problems through thorough history taking.• Co-ordinate and communicate with other community partners to link patients to treatment services.• Assisted with logistics of patient referrals.• Performed record keeping duties and periodic reporting to ensure adequate quality control.