I am currently studying software engineering in IT and Hr at Optimi College
Abigail Johnson
Quality Controller And Underwriter Medical Aid
South Africa
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals and have 20 years of administration(Data capturing and other back office experience),Quality Control and Underwriting,FSCA ,POPI ACT experience in previous companies.
Overview
1826
1826
years of professional experience
3
3
years of post-secondary education
Work History
Membership Clerk
Afrocentric Group-Medscheme
Gauteng
02.2008 - 12.2024
- Capturing of applications, new beneficiaries, option changes, and do continuation of members when going on retirement or in case of death of member loading of banking details
- Ensure that scheme rules are applied, and all administration duties are done example, Communication to member and brokers via email for outstanding information, faxing, copy, scanning etc
- Ensure that captured application accurately on system as per members applications and ensure that turn around time is adhered to.
Medical Underwriter
Afrocentric Group-Medscheme
Gauteng
02.2008 - 12.2023
- Doing underwriting and review potential members medical history and applications and define the risk profile
- Allocate appropriate underwriting risk mitigations protocols in line with the allowed scheme regulatory allowance (Medical Schemes Act)
- Review identified potential non-disclosure cases and make recommendations to the schemes on action to be taken.
- Reduced company losses by identifying potential risks and recommending appropriate mitigating measures
- Ensured compliance with regulatory requirements through diligent monitoring of industry changes and updating internal policies accordingly
- Achieved faster turnaround times in application processing by optimizing workflows within underwriting department
- Developed strong relationships with brokers, leading to higher volume of quality submissions and successful underwriting.
Quality Control Analyst
Afrocentric Group-Medscheme
Gauteng
02.200 - 12.2023
- Monitor and quality control data that is captured into system to ensure customer satisfaction and user efficiency.
- Make sure quality control target are met as per service level agreements.
- Meet delivery objectives through working with other team members within department.
- Resolve operational performance variations and problems and escalate unresolved issues to Managers.
- Make sure that delivery targets/objectives are met and operate in supportive manner to achieve successful deliveries.
- Ensure that all data processed is ISO compliant.
- Identify incorrect processed applications and returned to Underwriter and Membership Clerk to rectify
- Definitely contribute to cost savings within departments to assist with financial goal and target
- On monthly basis I engage in Coaching Membership Clerk ,Non declaration Clerk and Underwriter and also mentoring them.
- Arrange one on one monthly meeting via teams with membership clerk,non declaration clerk and underwriters to discuss errors that was made.
- Compile monthly report working out their errors and measure their performance.
- Help with monthly exception reports and service level agreement report
- Developed comprehensive quality control documentation, providing clear guidelines for staff adherence.
- Enhanced product quality by implementing rigorous testing procedures and protocols.
- Improved customer satisfaction by promptly addressing complaints and resolving product-related concerns.
Quality Controller-Membership Department
Afrocentric Group-Medscheme
Gauteng
02.2002 - 12.2023
- Monitor and quality control data that is captured into system to ensure customer satisfaction and user efficiency
- Make sure quality control target are met as per service level agreements
- Meet delivery objectives through working with other team members within department
- Resolve operational performance variations and problems and escalate unresolved issues to Managers
- Make sure that delivery targets/objectives are met and operate in supportive manner to achieve successful deliveries
- Ensure that all data processed is ISO compliant
- Identify incorrect processed applications and returned to Underwriter and Membership Clerk to rectify
- Definitely contribute to cost savings within departments to assist with financial goal and targets
- On monthly basis engage in Coaching Membership Clerk and Underwriter and also mentoring them
- Help with monthly exception reports and service level agreement report.
Medical Underwriter
Afrocentric Group-Medscheme
Gauteng
02.2008 - 12.2023
- Ensure purpose of this job was to sort and match correspondence to files and ensure that incoming mail is distributed to underwriters with shortest possible time elapsing
- Sorted mail into alphabetical order in sorter provided, for easy retrieval of pending files
- Matched correspondence to files noting surname, initials and date of birth of each client to ensure that correspondence is placed in correct files
- Checked all new business against main sorter for requirements which may have come into department
- Used to track files on t system and using inquiry screens
- Ensure that all original doctors reports received are returned to them after photocopy has been kept for medical files
- Call for files from head office central filing for re-instatement of policies as well as for additions and increases
- Maintain consistency and accuracy at all times
- Support close offs by being aware of close of dates and attending work over these periods of time
- Administration: General policy information, receipt of facsimile, letter or memorandum or by broker/agent appointment or information authorization notification to provide full policy/contract information values
- Checked validity of request example does customer signature appear on authorization and is request accompanied by relevant authorizations
- Refer appointment letter authorizations to be branch administrator for implementation by sales administration
- Obtain information on all contract/policies held with Sage life by checking database under client full name and date of birth
- Collation of all requested information
- Distribution by internal mail or facsimile or by hand of this information to source of request within service level agreement
- Refer all cases where values need to be manually calculated by actuarial services to branch administrator
- Beneficiary nomination
- Updating records with new beneficiary/nominee appointments
- Data capture to be checked day after for accuracy
- Requested then referred to branch administrator for processing of endorsement
- Data capturer
- Loading of new business cases and ensure that capturing was done accurately
- Ensure that all FICA documents has been completed by Agents and brokers
- Administrative duties done as required
- Ensure that scheme rules was adhered too
- After applications has been loaded it was sent to various underwriters to underwrite cases
- Ensure that all service level agreement is adhere too.
- Reduced processing time by effectively prioritizing tasks and organizing workflow among team members
Data Capturer
Momentum Health
South Africa
01.2006 - 02.2008
- Capturing of applications, new beneficiaries, option changes and loading of banking details
- Ensure that scheme rules are applied and adhered too
- Packing of medical aid cards and post and courier to different brokers and Universities and on individual member are normal posting
- Do correspondence by emailing all applications, claims, and statements to different types of Bins.
- Prepared monthly reports on membership statistics, providing valuable insights into trends and areas for improvement
- Supported organizational growth goals by actively participating in strategic planning meetings focused on increasing membership numbers and overall revenue
- Trained new hires on membership processes, contributing to cohesive team environment focused on excellent customer service
Education
Matric - Matric
Fred Norman Secondary School
Gauteng 12.2000 - 12.2000
Occupational Cert -NQF Level 5 Insurance Agent - Insurance Underwriter
ARTG Training Group
Rosebank 05.2019 - 05.2019
Certificate of Proficiency - Life Insurance
The Insurance Institutes of South Africa (IISA)
Parktown 05.2019 - 09.2022
Skills
Motivation skills
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I am a dedicated, organized and methodical individual. I have good interpersonal skills, am an excellent team work and am keen and very willing to learn and develop new skills. I am reliably dependable and often seek new responsibilities within a wide range of employment areas. I have an active and dynamic approach to work and getting things done. I am determent and decisively. Am also very friendly and willing person and always looking to be kept busy and am not afraid to take on workload
Personal Information
- Driving License: Code 8
- Marital Status: Married
References
- Mildred De Villiers, Manager Corporate schemes Medscheme, 0829663734
- Sakhile Gungqa, Manager Hosmed Medscheme, 073027894
- Rehaad Ally, Manager Momentum medical aid section, 0743468067
- Charmaine Linden, Manager, 0817393969, Sage financials
Interests
Playing the violin,love squash
Im currently an active Violinist playing in church orchestra and I love squash it keeps you active.
Timeline
Occupational Cert -NQF Level 5 Insurance Agent - Insurance Underwriter
ARTG Training Group
05.2019 - 05.2019
Certificate of Proficiency - Life Insurance
The Insurance Institutes of South Africa (IISA)
05.2019 - 09.2022
Membership Clerk
Afrocentric Group-Medscheme
02.2008 - 12.2024
Medical Underwriter
Afrocentric Group-Medscheme
02.2008 - 12.2023
Medical Underwriter
Afrocentric Group-Medscheme
02.2008 - 12.2023
Data Capturer
Momentum Health
01.2006 - 02.2008
Quality Controller-Membership Department
Afrocentric Group-Medscheme
02.2002 - 12.2023
Matric - Matric
Fred Norman Secondary School
12.2000 - 12.2000
Quality Control Analyst
Afrocentric Group-Medscheme
02.200 - 12.2023
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