Hospital Benefit Specialist | Talent Pool - Gauteng and KwaZulu-Natal

Discovery’s purpose is to make people healthier and protect lives. We invest in exceptional individuals whose values align with our mission. Our dynamic environment empowers smart, self‑driven people to deliver innovative solutions that achieve financial success and meaningful change.

Hospital Benefit Specialist

As part of Discovery Care, a subsidiary of Discovery Health, the Hospital Benefit Specialist works within the Chronic & PMB Management team, handling chronic and prescribed minimum benefit requests, resolving escalated clinical queries, and coordinating real‑time risk management. The role supports the Managed Care programs and ensures members receive appropriate care.

Key Purpose

The successful applicant will:

• Assess each case in relation to the member’s clinical history, benefit structure, supplied coding, level of care, facility and treating physician, and treatment appropriateness.
• Manage benefits for the memb...