Dental Risk Consultant

About

Description

An exciting and challenging opportunity exists for an energetic, detail-oriented, and results-focused Dental Risk Consultant at PPS Healthcare Administrators. The successful candidate will be responsible for Dental Risk Management in a call centre environment, acting as a customer ambassador to ensure effective resolution of clinical queries, pre-authorisations, and case management for dental-related benefits.

Responsibilities

• Manage the pre-authorisation and case management process telephonically, via email, and chat Ensure compliance with scheme rules for authorisations and clinical updates Allocate facilities correctly for members Handle clinical queries from both internal and external stakeholders Assist with dental risk management and monitoring of hospital readmissions Compile and submit cost and patient progress reports to the scheme

Qualifications

• Grade 12 (Matric) Bachelor's Degree Essential: Experience in Dental Risk Management Strong knowledge of ICD10 & CPT4 coding systems Understanding of Medical Aid industry rules, regulations, ISO standards, and relevant legislation Strong communication (verbal and written) and telephone etiquette Time management and administrative skills Computer literacy (MS Office and medical administration systems) Team player with strong results-driven attitude

Application instructions:

• Apply online via the PPS Careers Portal before 30 May 2025. Prepare your updated CV and ensure all required fields in the online application form are completed.