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Melissa Julies

Clinical Hospital Pre-authorisations Consultant

Talent
Retreat, Cape TownMember since June 17, 2026
Medical administration systems
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Medical administration systems

About

I am seeking to leverage my broad skill set in a role that allows me to utilise my administrative, recruitment, and medical knowledge. I aim to contribute to an organisation that values dedication, adaptability, and comprehensive skill integration. I am an adaptable, teachable team player with 13 years of experience living and working in Australia.

Experience

Clinical Hospital Pre-authorisations Consultant - Medscheme

(2023-01)

  • Reviewing and assessing hospital pre-authorisation requests for compliance with Bonitas medical scheme policy
  • Collaborating with healthcare providers and patients for efficient processing of authorisations
  • Maintaining accurate records of all pre-authorisation activities
  • Evaluating patient documentation to determine medical necessity for medical procedures
  • Developing strong relationships with medical professionals for cooperative patient care management
  • Verifying ICD-10 and CPT coding accuracy on submitted claims
  • Liaising with specialists regarding clinical motivations and treatment plans
  • Managing case escalations and appeals processes for declined authorisations
  • Ensuring compliance with PMB regulations and scheme-specific protocols
  • Capturing and updating patient data on internal medical administration systems
  • Educating members on benefits as per medical aid plans

Patient Pre-admissions Nurse - Mediclinic Constantiaberg

(2023-01)

  • Patient pre-admissions prior to joint replacement surgery
  • Providing information and completing pre-op documents and assessments
  • Educating patients on procedures and medications prior to operation
  • Conducting ward visits to monitor patients during their stay
  • Preparing documents for post-op rehabilitation/stepdown
  • Arranging post-op consultation appointments

Clinical Consultant - Marie Stopes

(2021-01 - 2022-12)

  • Client services discussing aftercare telephonically post procedures
  • Assessing symptoms post procedures
  • Clinical advising on need for urgent medical care
  • Providing empathetic support to clients during sensitive post-procedure periods
  • Coordinating with medical staff for timely interventions
  • Documenting all interactions accurately

Reception/Admin Role - Bytes Document Solutions

(2019-09 - 2020-02)

  • Answering switchboard and directing calls
  • Processing procurement purchase orders
  • Administration duties with Sales admin
  • Petty Cash reconciliation
  • Managing front reception and office running
  • Ordering stationery, groceries
  • Arranging catering for office events/meetings

Enrolled Nurse - Maternity/Obstetrics & Gynaecology - Joondalup Health Campus, Australia

(2015-09 - 2019-01)

  • Working alongside Midwives to support new mothers with newborns
  • Providing care to pregnant women prenatally and postpartum
  • Preparing patients for theatre for Caesareans
  • Administering oral/IV medications as prescribed
  • Instructing and counselling new mothers in handling and breastfeeding
  • Assisting with baby observations, weights, newborn screening, oxygen saturations
  • Administering Hepatitis B, MMR vaccinations and Anti-D
  • Attending to pre- and post-operative gynaecology patients
  • Completing nursing discharge planning and wound care

Graduate Enrolled Nurse - Graduate Nursing Program - Joondalup Health Campus, Australia

(2015-03 - 2016-03)

  • Twelve-month program with two six-month rotations (Rehabilitation/Geriatrics and Obstetrics/Maternity)
  • Attended regular study days and completed assessments on both rotations
  • Worked under supervision of Registered and Clinical nurses within scope of practice
  • Completed IV medication competency

Community Support Worker - Juniper Community Services, Australia

(2014-05 - 2015-02)

  • Assisting clients within home with activities of daily living
  • Completing domestic and shopping services
  • Medication administration and meal preparation

Community Support Worker - Multiple Sclerosis Society, Australia

(2014-03 - 2014-04)

  • Assisting MS clients with activities of daily living
  • Hoisting clients safely, PEG feeding
  • Medication administration and meal preparation
  • Social activity to relieve carers

Employment Consultant - Salvation Army Employment Plus, Australia

(2008-08 - 2014-02)

  • Providing recruitment services to employers
  • Caseload management of 100 candidates
  • Helping candidates with job search, applications, resumes, and cover letters
  • Post placement support
  • Negotiating employment pathway plans
  • Arranging and booking training with RTOs and employment medicals
  • Referring and arranging counselling services
  • Mentoring job seekers
  • Managing outreach services in Ellenbrook
  • Identifying employment, training, upskilling and retraining opportunities
  • Updating database with client records and documents
  • Processing purchase orders for suppliers

Education

Diploma - Enrolled Nursing - Central Institute of Technology (2012-01 - 2014-12)

Cert IV - Business Human Resources - TAFE (2007-01 - 2007-12)

Year 12 - Spes Bona High School (1999-01 - 1999-12)

Skills

Clinical Hospital Pre-authorisations Consultant

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