Andy Struppmann

• Clinical coding of weekly new NAPPI codes.
• Safeguarded sensitive information through proper documentation handling, data entry, and record maintenance procedures.
• Updating formularies with all relevant new NAPPI codes.
• Maintaining different reference pricing models and preparing monthly communications.
• Sourcing of clinical information on newly launched products, through various sources.
• Maintenance of all vital fields on the Mediscor Drug Database.
• Price maintenance of SA product prices as well as international clients.
• Sourcing product information, package inserts, and pricing.
• Internal departmental as well as external client support and feedback.
• Quality control on the Mediscor Product Database.
• Test and Quality Assurance (QA) new developments on the Mediscor Product Database.
• Updating Department of Health pricing and new products.
• Handling stock queries and alternatives.
• Answered incoming phone calls to process requests, transfer calls, or relay messages to appropriate personnel.
• Strengthened client relationships through consistent follow-up communication and efficient problem resolution.
• Collaborated effectively with cross-functional teams to achieve shared goals in a timely manner.
• Created training videos for various aspects of the job.

• Enrolling members on the HIV and Diabetes care program.
• Retrieving and capturing pathology for members.
• Completing Care plans with Out of Target members.
• Answering all incoming calls, mails, and call backs.
• Educating members on their chronic conditions and adherence.
• Liaising with Doctors rooms and laboratories for results and prescriptions for authorizations.
• Ensure high standards of service as stipulated by the Serviced Level Agreements with the clients (quick response to answering and quality of the call) as per company policy.
• Ensure correct procedure for new patient enrollment is followed as stipulated by the company policies and procedure.
• Ensure correct procedure for the processing of new and repeat prescriptions and blood results from laboratories.
• Ensuring timeous and speedy resolution to all queries with emphasis on escalated queries.
• Ensuring that all relevant assignments are processed in a timeous manner.
• Patient education interacting with patients on a weekly/ 6 monthly basis via SMS and telephone (Depending on the situation)
• Counseling and implementing an adherence strategy. (Include structured telephonic interviews -recorded and noted – to establish a monthly self report from patients and pill counts and follow visits and follow up on Doctor visits and laboratory tests.
• Regular contact between agent and intervention patient as determined by the system to build an open respectful relationship with the patient.
• Regular and aggressive follow up (blood results, renal function tests, pill counts or pill checks and repeat prescriptions are checked captured and managed) with focused intervention patients.
• Report cases which require referral to other services e.g substance , depression, treatment compliance etc diagnosed early and referred to appropriate services) to the line manager.
• Always ensure total confidentiality and professional conduct when liaising with patients telephonically, in writing or in person.
• Liaise with treating doctors receptionists and patients to ensure prescriptions and pathology tests done 6 months as per protocol.
• Report all outstanding prescriptions and/or pathology to the line manager.
• Report cases for focused intervention and intervention to the line manager for management as per protocol.
• Ensure confirmation of contact details and alternative contacts.
• Ensure adherence to Halocare work flow process and protocols.
• Ensure data is captured and processed correctly within the required time as per the service level agreement with the clients( hours for all new registrations,prescriptions and queries.
• Submit processed work to line manager within the time required.

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• The timeous resolution of pharmaceutical queries form members, pharmacists, and medical aids.
• Advising members on scheme rules, medical aid formularies and authorization procedures.
• Resolving OTRS queries in a timeous fashion.
• Assisting in the Diabetes enrolments for Halocare
• Monitoring and logging downtime.
• Reversals, Early refills, and Date of birth overrides.
• Providing first point of contact for customers by determining the type of query received.
• To ensure queries received are handled efficiently and and appropriately in line with the relevant SLA’s.
• Ensure that all systems are up and running (Q – contact, Iseries, Mediscor intranet and anita) – Report system faults to Senior claim specialist.
• Ensure incoming call are answered within 4 rings as per the SLA.
• Ensue all systems are up and running to perform daily tasks – report system faults to Claim Specialist
• Ensure incoming calls are answered within 4 rings as per SLA.
• Receive calls from customers and determine the type of query and use systems to resolve the query efficiently
• If you are unable to resolve the query due to the complexity of the query, escalate it to the Claims Specialist.
• Attempt to deal with difficult or irate customers before escalating it to the Claims specialist or assistant manager.
• Update correct wrap up code and notes at the end of every interaction.
• Maintain agreed amount of time on available status (monthly/weekly) as per internal SLA.
• Collect the downtime file and verify matrix per scheme
• Monitor systems at 15 min intervals.
• Follow laid down procedures using file on hand and contact the relevant people ( either telephonically or via email) so that it can be addressed.
• Log downtime on relevant platform
• Check system periodically to see when its back online and check that claims are being processed.
• Update pharmacy information as information is given.
• Advise the Pharmacy Management Administrator once the system has been updated.
• Update pharmacy information on the spreadsheet as per SOP on a weekly basis.
• Remain available during peak periods
• Tend to queries in average handle time
• Complete allocated adhoc projects within specified time frame.
• Assist with Halocare admin functions
• Assist with Chroniline admin functions
• Organize departmental recourses to ensure all system , client and SLA requests are implemented before the due date.
• Give regular feedback to staff members on their performance and progress by doing monthly one on ones. Feedback includes resolving conflict, identifying training needs and areas of improvement.
• Managed high call volumes while providing exceptional customer support and maintaining professional composure.
• Handled escalated calls professionally, effectively resolving complex issues and ensuring client satisfaction at all times.

• First call resolution for clients and all inter branch queries
• Adhering to strict SLA and KPI’s as set out by clients and contractors
• Pricing, Part sourcing and quoting
• Parts ordering, receipting, logging and allocation
• Invoicing and new client accounts
• Increased client satisfaction by providing timely and effective troubleshooting support for various technical problems.
• Discussed project progress with customers, collected feedback on different stages and directly addressed concerns.
• Conducted regular quality assurance checks identify resolve any potential issues before they impacted end-users or system performance.
• Collaborated with fellow engineers to evaluate software and hardware interfaces.