Prior Approval Administrator

Job Description

About the Role

Are you detail-oriented, organised, and passionate about delivering exceptional service in healthcare administration? We are seeking a proactive Prior Approval Administrator to join our Shared Service Centre, supporting Ashtead, North Downs & Berkshire Independent Hospitals.

In this crucial role, you will process pre-authorisations for all Insured and NHS admissions, working closely with sites, external referrers, insurance companies, NHS commissioners, and hospital staff to ensure a smooth and efficient approval process. Your work will directly impact patients' access to vital treatments and support the hospital's commitment to excellent care.

Main Duties and Responsibilities

• Work efficiently with hospital sites to obtain pre-authorisations for all Insured and NHS admissions.
• Communicate professionally with external referrers, insurance companies, NHS commissioners, and hospital staff to facilitate prompt approval of admissions.
• Ensure all activities and processes strictly adhere to governance guidelines for funding and patient treatment.
• Obtain prior approval from relevant commissioners, securing necessary funding under NHS guidelines where required.
• Keep up to date with changes to procedures, thresholds, and requirements, maintaining a strong working knowledge of current practices.
• Meet established KPIs for timelines ahead of the Targeted Care Initiative (TCI) for prior approval.

Key Deliverables

• Secure timely pre-authorisation for all Insured and NHS admissions.
• Consistently meet KPIs relating to timelines ahead of admissions.
• Adhere to specific funding guidelines, ensuring compliance in all processes.

Performance Metrics

• Efficiency and accuracy in obtaining pre-authorisations.
• Adherence to timelines and KPIs.
• Compliance with governance and funding guidelines.

What We’re Looking For

• Experience in healthcare administration or a related field (preferred but not essential).
• Excellent communication and interpersonal skills.
• Ability to work collaboratively with diverse stakeholders and across multiple sites.
• Proactive approach to problem-solving and process improvement
• Strong organisational skills and attention to detail.

Benefits

• 25 Days Leave + Bank Holidays

• Buy & Sell Flexi Leave Options

• Private Pension where Ramsay will match up to 5% after a qualifying period

• Enhanced Competitive Parental Leave Policies

• Private Medical Cover with option to add partner & dependants

• Life Assurance (Death in Service) x3 base salary

• Free Training and Development via the Ramsay Academy

• Concerts for Carers

• Employee Assistance Programme

• Cycle2Work scheme available, in partnership with Halfords

• The Blue Light Card Scheme

About Us

Ramsay Health Care UK is a well-established global hospital group with over 60 years’ experience. We are a global provider operating in 8 countries, with 88,000 staff who treat 8 million patients each year. It is well respected within the healthcare industry and is one of the leading providers of independent hospital services in England. We are well known for our strong, long-standing relationship with the NHS.

We love people with a positive, “can do” attitude who want to make a difference in their work. "Our employees are Ramsay." The skills and commitment of our employees forms the basis for our success.

We care.
 

It’s more than what we do, it’s who we are. Everything we do is about striving to deliver the best care. And it's a belief that's as true today as it was when we welcomed our first patients in 1964.
 

“The Ramsay Way” culture recognises that our people are our most important asset and this has been key to our ongoing success.

We are proud to support the UK’s Armed Forces and Reservists and have already achieved the Silver Award as part of the MOD’s Armed Forces Covenant Employer Recognition Scheme. The scheme recognises employers who actively support Defence while encouraging other organisations to adopt the same behaviours in their workplace. As a company we are committed to supporting the wider Armed Forces community and this includes our staff as well as our patients.

We are committed to equality of opportunity for all. This position is subject to background and DBS checks.