Andile Ngidi
Query Claims Assessor
Soweto
Overview
3
3
Languages
2027
2027
years of professional experience
Work History
Medical claims Assessor
Medscheme Holdings
2016 - 2019
- Capture Claims into Nexus System
- Reason for Leaving: Internal Transfer
- Job Description: Administration
Claims Assessor and 2IC
Medscheme Holdings
2019 - 2024
- Preform general assistant duties in the department and administrative duties
- To ensure that all medical aid claims are accurately captured
- Branch Network claims Assessing and Pre-Assess Medical claim
- Resolve Queries External and Internal
- Provide feedback to consultant about member queries
- Ensure that scheme rules are applied appropriate
- Assist CLO’s on wellness event with face to face member queries
- Assist Gems Script renewal
- 2IC Duties: Departmental Monthly Quality report
- Look after the department
- Ensure work flow is in place
- Ensure everyone is working and TAT is not compromised
- Attend Scheduled meeting
- Be the Go to person
- Also training / buddying as a Client Service Consultant (CSC)
- Also from time to time assists with face to face member queries
- Experience Gained: Organizational Skills and Customer Interaction Skills
Query Assessing Specialist
Medscheme Holdings
2024 - Current
- First contact Resolution
- Process claims as per schemes rules
- Ensure Claims are captured correctly
- Collaborated with cross-functional teams to achieve project goals on time and within budget.
- Improved customer satisfaction rates through proactive problem-solving and efficient complaint resolution.
- Followed all company policies and procedures to deliver quality work.
- Championed the adoption of new software tools that streamlined workflows across multiple departments.
Education
Business Administration NQF Level 4 - 141 credits, NQF 5 Wealth Management
People Solutions
03-2017
Business Management N4-N5 - Accounting, Business Communication, Entrepreneurship Management, Sales Management and Computer Literacy
South West Gauteng College
01-2013
Contact Centre NQF Level 2 - 128 credits
Rand International Institution
01-2012
Grade Twelve (MATRIC) - Zulu, English, Economics, Accounting, Business Economics
Lavela High School
01-2006
Skills
Documentation review
Professional ethics
Policy interpretation
Assertiveness
References
- Muzi, Khumalo, Branch Team Leader, 011 7588742
- Tanya, Barnard, Branch Network Manager, 011 758 8019
- Nadine, Viljoen, Client Liaison Manager, 011 671 4832
ACKNOWLEDGEMENT
- I am a gently confident someone who believes in efficiently handling any queries hands-on and as quickly as possible. I believe I am humble person who is always eager to learn and grow intellectually and am a quick learner.
- For any further information, please do not hesitate to contact me as I am available immediately.
Timeline
Grade Twelve (MATRIC) - Zulu, English, Economics, Accounting, Business Economics
Lavela High School
Contact Centre NQF Level 2 - 128 credits
Rand International Institution
Business Management N4-N5 - Accounting, Business Communication, Entrepreneurship Management, Sales Management and Computer Literacy
South West Gauteng College
Business Administration NQF Level 4 - 141 credits, NQF 5 Wealth Management
People Solutions
Medical claims Assessor
Medscheme Holdings
2016 - 2019
Claims Assessor and 2IC
Medscheme Holdings
2019 - 2024
Query Assessing Specialist
Medscheme Holdings
2024 - Current