Medical Aid Administrator

Description

Healthcare Authorization Specialist

Location: Fully Remote - South Africa

Working Hours: 9am - 5pm EST

Salary: R26 500 - R30 000

About the Role

We are looking for a detail-oriented, tech-savvy Healthcare Authorization Specialist to support a growing, home-based Applied Behaviour Analysis (ABA) business.

In this role, you will be responsible for preparing and submitting insurance authorization requests, gathering supporting documentation, navigating insurance company portals, and tracking authorization requirements to ensure submissions are accurate and completed on time.

Previous healthcare insurance or ABA authorization experience is beneficial but not essential. The client is particularly interested in candidates who are intelligent, computer-proficient, resourceful, and capable of learning new systems and processes quickly. Training will be provided by the existing authorization specialist.

Requirements

Key Responsibilities

• Prepare and submit healthcare insurance authorization requests accurately and efficiently.
• Gather, organize, and verify supporting documentation required for authorization submissions.
• Complete payer-specific forms and navigate various insurance company portals.
• Track authorization requests, submission statuses, requirements, and outstanding documentation.
• Research insurance requirements and independently troubleshoot issues with online portals and submission processes.
• Contact insurance companies when clarification or additional information is required.
• Submit authorization requests through online portals and fax where applicable.
• Follow detailed procedures and maintain accurate electronic records.
• Identify and resolve routine issues independently, escalating more complex matters when necessary.

Requirements

• Strong general computer literacy and confidence navigating online systems.
• Excellent attention to detail and the ability to follow detailed instructions.
• Strong problem-solving, reasoning, and research skills.
• Ability to learn new software, insurance portals, and processes quickly.
• Comfortable working independently and managing tasks with minimal supervision.
• Good written and verbal communication skills.
• Strong organizational skills and the ability to track multiple requests accurately.
• A proactive approach to troubleshooting and resolving issues.

Preferred Experience

The following experience would be advantageous but is not required:

• Healthcare insurance, medical administration, or insurance authorization experience.
• ABA (Applied Behaviour Analysis) industry experience.
• Experience using Availity or other healthcare insurance portals.
• Experience with North Carolina or Minnesota insurance authorization processes.
• Experience preparing and submitting insurance documentation electronically or via fax.
• Familiarity with electronic document management systems.

What Success Looks Like

The successful candidate will be able to learn the authorization process during training and then confidently manage day-to-day responsibilities with minimal supervision. They will demonstrate strong computer navigation skills, accuracy, sound judgment, and the ability to find solutions rather than relying on constant guidance.

Please note: Candidates do not need extensive experience or a long list of qualifications to be considered. Practical computer skills, independent thinking, accuracy, and the ability to learn quickly are the most important factors for success in this role.