Abigail Johnson
Gauteng
Summary
Experienced professional with a strong background in administration, quality control, and customer service within the medicalaid and insurance sectors. Demonstrated expertise in managing membership applications, verifying data accuracy, and ensuring compliance with industry standards. Proven ability to deliver exceptional service, manage costs effectively, and collaborate across departments to achieve organizational goals. Adept at handling high-pressure situations with attention to detail and time management skills. Career goal: To leverage extensive experience in administrative support and quality assurance to contribute to a dynamic organization's success.
Overview
24
24
years of professional experience
4
4
Certification
Work History
Receptionist - Seasonal Worker
MRC/Wits DPHRU
12.2024 - 05.2025
- Provide efficient and effective administration support to ensure accuracy in the functional area.
- Handle inbound and outbound calls for participants professionally.
- Print and file contracts.
- Assist with scanning or emailing HR files.
- Open doors for participants and walk-ins, and assist staff without access cards.
- Receive general enquiry phone calls, often from participants, and handle delivery drop-offs.
- Able to work under pressure.
- Inform staff when they either have participants by the reception, or have a delivery for their attendance.
- Coordinated WhatsApp alerts to keep team updated on new information.
- Manages enquiries from staff members, participants, and visitors.
- Filing procurement and HR documents.
- Deliver exceptional service that exceeds customers' expectations through proactive, innovative, and appropriate solutions.
- Manage costs and expenses within the approved budget.
- Conduct regular audits and quality assessments.
- Ordered office supplies, maintained inventory, and ensured timely replenishment.
- Coordinate with vendors to arrange deliveries, and resolve issues.
- Collaborate with other departments to ensure alignment and consistency.
- Ensure that all admin gets done within turnaround time.
Roving Medical Administrator
De Muelenaere Oncology
08.2024 - 11.2024
- Inputted data into electronic database based on application form.
- Ensure effective and efficient management of appointments.
- Comply with SOP requirements in maintaining documents.
- Organized appointments for medical professionals.
- Facilitated the acquisition of medical reports, blood tests, and histology from different labs.
- Coordinate patient's medication orders.
- Arranged appointments in the radiology department.
- Arranged urgent medical travel through coordination with embassy officials.
- Organized and prepared necessary paperwork to support travel requirements for patients.
- Executed timely management of travel document procedures.
- Collaborated with medical professionals and embassy officials to ensure the patient received necessary care.
- Submission of prescriptions to medical aids.
- Booking oncology counseling session.
- Requesting authorization for hospital admissions.
- Consultation, billing, and medication authorization and medication authorization request.
- Strong patient flow.
- Legal frameworks surround my role and responsibilities.
- Positive relationships with our patients.
- Roving between different hospitals (We strand, Ahmed Kathrada, Sandton, and JSO Hospitals).
- Provide expert clerical support to clerks' management by answering phones, copying records, and implementing a record filing system.
- Calling patients by confirming follow-up appointments.
- Booking treatments for patients.
- Ward patients add to DMO ward list.
- Meet patients on arrival, and create a welcoming environment.
- Manage patients from arrival until departure.
- Assisting with ad hoc duties, as required.
- Manage good relationships with various suppliers, staff, and management requirements.
- Improve business decisions by providing accurate and reliable business intelligence.
- Managed patient records with strict confidentiality, adhering to GDPR and medical ethics.
- Managed procurement of office supplies and medical equipment.
Quality Controller
Afrocentric Health medical aid
04.2016 - 12.2023
- Conducted quality assurance for data capturers, underwriting clerks, and non-declaration clerks according to received documentation.
- Verified ID documents, bank statements among other necessary forms for accuracy.
- Audited information processed into systems for correctness.
- Facilitated precise updating procedures across departments including membership clerks, underwriters, and non-disclosure staff.
- Assisted in clearing backlogs for membership and underwriting.
- Assessed and validated the incorporation of LJP late joiner penalties in underwriters'
- Authorized banking details for system transactions.
- Implemented coaching strategies for employees showing signs of underperformance.
- Verified consistency of information within Nexus system member records.
- Generated monthly reports for membership clerk, underwriting clerk, and non-disclosure clerk to evaluate target achievement.
- Assessed adherence to service level agreements (SLAs) through detailed report analysis each month.
- Appointed ISO lead to streamline document management.
- Conducted monthly ISO training sessions for system navigation in preparation for auditors.
- Conducted timely updates to align underwriting policies with regulations.
- Implemented timely review of policies, procedures, and working instructions.
- Version Control: Maintaining a clear history of document versions to prevent confusion and errors.
- Managed document control using SPP system.
- Ensured security of documents with strict access control measures.
- Implemented strategies for handling documents according to legal guidelines.
- Identify and resolve membership discrepancies.
- Develop and implement quality processes.
- Conduct regular audits and quality assessments.
- Provide training and support to membership teams, and underwriting teams.
- Identify areas for process improvement.
- Partner with various departments to achieve consistency.
- Ensure compliance with regulatory requirements and industry standards.
- Develop corrective actions and address quality issues.
- Recorded quality reports tracking error and discrepancy rates.
- Data analytical report, trends in membership growth or decline, underwriting performance trends.
- Collaborated in credit control to mitigate bad debt.
- Tracked and managed outstanding payment statuses.
- Handling credit notes.
- Ensuring compliance with credit control policies.
Underwriter
Afrocentric Health medical aid
07.2011 - 03.2016
- Identify potential exclusions by reviewing medical records and applications to determine if any conditions or treatments should be excluded from coverage.
- Evaluate risk associated with covering specific medical conditions or treatments.
- Applied exclusion criteria to specific members and groups using set guidelines.
- Decision on the length of time an exclusion will be in place, based on specific circumstances.
- Clearly explain exclusion to members.
- Verify exclusion decisions align with industry regulations, laws, and company policies.
- Assess whether a member is eligible for coverage, considering factors like age, health status, and membership history.
- Calculate late joiner penalties and determine the penalty amount or premium adjustment for members who join the scheme late, or after a qualifying event (turning 35).
- Applied penalties in accordance with company guidelines based on member age, health, and duration of non-coverage.
- Clearly explain member late joiner penalties and their implications to members or their representatives.
- Explain to members that late joiner penalty decisions align with industry regulations, laws, and company policies.
- Collaborate with the membership team to maintain precise records of member histories.
- Document management: collecting, scanning, and uploading supporting documents.
- Maintained accurate records.
- Maintained cost efficiency.
- Reviewing files for accuracy and completeness.
- Ensured detailed tracking by assigning appropriate ICD-10 codes.
- Handled inbound and outbound calls.
- Engaged with customers to better understand needs and deliver excellent service.
- Handled customer concerns and escalated major issues to supervisor.
- Conducted yearly evaluations of underwriting policies and implemented necessary corrections.
- Facilitated administrative upload by obtaining supervisor clearance.
Membership Clerk/Data Capturer
Afrocentric Health medical aid
02.2008 - 06.2011
- Captured new applications coming from brokers, members, pay points, marketing, walk-in branch, CLO, and Scheme internal sales contact.
- Maintained efficient data entry processes for electronic systems.
- Requested missing information efficiently.
- Provide efficient and effective administration support to ensure accuracy in the functional area.
- Delivered exceptional support to members and healthcare providers.
- Managed yearly updates of plan options for members.
- Designed and issued membership cards.
- Maintaining confidentiality and adhering to data protection regulations.
- Collaboration with other departments, such as claims and underwriting.
- Identify and resolve discrepancies.
- Maintained productivity and quality benchmarks.
- Managed urgent inquiries, showcasing the capacity to perform well under pressure.
- Updated policies, procedures, and work instructions annually according to ISO standards.
- Resolved customer queries and problems using effective communication and providing step-by-step solutions.
- Ensure to adhere to new business procedure.
- Prepared monthly reports on membership statistics, providing valuable insights into trends and areas for improvement.
- Trained new hires on membership processes, contributing to a cohesive team environment focused on excellent customer service.
- Provided exceptional customer service by actively listening to member concerns and offering appropriate solutions or referrals as needed.
Document Custodian
Momentum Medical aid
01.2007 - 01.2008
- Receiving, sorting, and organising documents for scanning.
- Preparing documents for scanning, including removing staples and paperclips.
- Scanning documents using specialised software and equipment.
- Maintaining the security and confidentiality of sensitive documents.
- Verifying the quality and accuracy of scanned images.
- Indexing and categorising scanned documents for easy retrieval.
- Uploading scanned documents to digital storage systems or databases.
- Implementing quality control measures to prevent errors or lost documents.
Data Capturer
Sage Life Insurance
09.2001 - 12.2006
- High degree of accurately capturing and entering policy information, including policy numbers, coverage, and premium amounts.
- Input and maintained customer information such as names, addresses, and contact details in company systems.
- Recorded medical information for insurance claims.
- Captured updated risk information, including changes to policyholders' information and risk exposures.
- Verified data accuracy and completeness, ensuring compliance with regulatory requirements.
- Collaborated with colleagues to ensure a timely and accurate data capture process.
Education
Master of Arts - OSUN Research-Creation course on the arts and migration
University of The Witwatersrand
Parktown06.2025
Certificate - Research Ethics Evaluation
TRREE
Online06-2025
High School Diploma -
Fred Norman Secondary School
Ennerdale 12.2000
Skills
- Organization skills
- Time management
- Telephone skills
- Data entry
Certification
- 08/2019 Occupational certificate NQF level 5 | Medical aid, Short term, Long term Insurance Agent -Insurance Underwriter ARTG - smarterlearning -Inseta
- 05/2004 Certificate of proficiency Life insurance 1 IISA
- 03/2025 IT Technician | COMPTIA A+220-1101 and COMPTIA A+ 220-1102 certificate obtain Optimi College
- 08/2025 Research Ethics Evaluations| Introduction to Research ethics-certificate obtain Research Ethics Evaluation-certificate obtain Informed Consent -certificate obtain Good clinical pretice- certificate obtain HIV Vaccine Trials -certificate obtain Adolescent involvement in HIV prevention Trials- certificate obtain Public Health Researcg Ethics-certificate obtain TRREE- Training and Resource in Research Ethics Evaluation
LANGUAGES
English: Proficient
Afrikaans: C2 Proficient
WEBSITES, PORTFOLIOS AND PROFILES
https://www.linkedin.com/in-johnson- HYPERLINK "http://www.linkedin.com/in-johnson-a62886140"a62886140
Timeline
Receptionist - Seasonal Worker
MRC/Wits DPHRU
12.2024 - 05.2025
Roving Medical Administrator
De Muelenaere Oncology
08.2024 - 11.2024
Quality Controller
Afrocentric Health medical aid
04.2016 - 12.2023
Underwriter
Afrocentric Health medical aid
07.2011 - 03.2016
Membership Clerk/Data Capturer
Afrocentric Health medical aid
02.2008 - 06.2011
Document Custodian
Momentum Medical aid
01.2007 - 01.2008
Data Capturer
Sage Life Insurance
09.2001 - 12.2006
Master of Arts - OSUN Research-Creation course on the arts and migration
University of The Witwatersrand
Certificate - Research Ethics Evaluation
TRREE
High School Diploma -
Fred Norman Secondary School
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