Bronwin Carr

Main Point of Contact for Payment Arrangements

• Served as the primary contact for inquiries and communications related to payment arrangements.
• Established and maintained strong relationships with key Medical Schemes, SpesNet, and other relevant parties to facilitate transparent communication between VeriClaim and the Medical Schemes.
• Stayed informed about changes in payment arrangements, fixed fees, provider-specific agreements, and how fixed fees influence payment arrangements.

Payment Arrangement Management

• Took ownership of new or changed payment arrangements, ensuring thorough investigation, information gathering, understanding of the changes, and compilation of change requests for updates to VeriClaim.
• Maintained up-to-date knowledge of payment arrangements on VeriClaim, conducted regular analysis to ensure correct implementation, and suggested improvements to workflows and efficiencies.
• Kept accurate and detailed records of documentation related to payment arrangements and regularly updated these records.

Knowledge Sharing and Training

• Ensured all MediCharge staff were knowledgeable about payment arrangements and their implementation on VeriClaim through training, upskill sessions, and providing guidance with necessary training materials and reference guides.

Scheme and Tariff Management

• Maintained a functional understanding of Scheme increases, Scheme rules, Conversion Factors, payment arrangements, the VeriClaim Billing Engine, and the Tariff App.
• Assisted with obtaining tariff files and general tariff-related queries, as well as payment arrangement information.
• Co-managed and coordinated all tariff files/payment arrangements throughout the year and during year-end, including quality assurance, interpretation, accurate loading, calculation, and updating of rand conversion factors.
• Maintained and managed a report or control sheet indicating when and why tariffs/payment arrangements were amended or updated on VeriClaim.

Coordination and Support

• Coordinated all tariff and payment arrangement-related issues, queries, and updates, providing support for resolution to practices, internal staff, and third parties.
• Created change request documents for the implementation of new payment arrangements.
• Ensured effective and insightful communication with Medical Schemes, including asking pertinent questions to obtain necessary answers for optimal tariff query resolution.

• Streamline and improve operational processes within the healthcare facility to enhance efficiency and reduce costs
• This may include optimizing patient flow, scheduling, and resource allocation
• Oversee the allocation of resources such as staff, equipment, and supplies to ensure they are utilized effectively
• This includes managing staff schedules and ensuring appropriate staffing levels
• Implement and monitor quality control measures to ensure that healthcare services meet or exceed established standards and regulations
• This may involve developing and implementing quality improvement initiatives
• Ensure that the facility complies with all relevant healthcare regulations
• Monitor patient satisfaction levels and work to improve the patient experience
• Address complaints and concerns from patients and their families
• Supply Chain Management: Manage the procurement and distribution of medical tests in collaboration with the biomed team
• Implement and oversee the use of healthcare information systems (such as electronic health records) to improve data accuracy and streamline processes
• Recruit, train, and mentor staff members
• Foster a culture of continuous learning and professional development
• Collaborate with other departments, healthcare providers, and external partners to ensure smooth operations and the delivery of comprehensive patient care
• Participate in the development and execution of long-term strategic plans for the healthcare facility
• Assess and mitigate operational risks that could impact patient care
• Maintain effective communication channels within the organization to ensure that all staff members are aligned with operational goals and objectives
• Establish and track key performance indicators (KPIs) to assess the facility's performance and identify areas for improvement.

• Plan, organise and coordinate the daily operations of the centre and provide leadership and guidance to team members in a way that drives performance and maximises efficiency and cost-effectiveness
• Oversee the investigations and the enhancements processes of the system
• Manage the department that performs the investigation of the enhancement, including approving and drawing up the technical documents that are required by the Development team to add the new features on the system
• Develop objectives for the centre's day-to-day activities and conduct effective resource planning to maximize productivity
• Hire, train and oversee staff to handle customer service issues and ensure superior quality service delivery to internal and external customers
• Enforce health and safety guidelines and ensure the staff and facility comply with all applicable laws and industry regulations
• Compile, implement and monitor individual KPIs to ensure maximum productivity
• Ensuring effective management and control of queries and issue escalations to the development team
• Establish, building and maintain strong customer relationships and ensure open communication channels to facilitate service delivery excellence
• Analyse stats, draw relevant conclusions and present recommendations on how to improve the department
• Review technical specification documents and provide relevant support
• Manage and oversee urgent queries and communicate with the development team to ensure prompt resolutions
• Oversee and review implementation of system enhancements and ensure accuracy thereof
• Conduct audits and assessments on staff output and compile reports
• Provide support to staff in assisting external users on using system functionalities
• Proficient understanding of medical billing, processes and credit control
• Implement and manage the budget, ensuring optimised operations within the set budget.

• Coordinated and managed support staff, with a specific focus on driving performance to ensure customer service excellence
• Assisted in compiling, communicating, and implementing objectives and targets to the team and completed support staff evaluations
• Compiled SOP's and provided guidance in accordance with SOP's
• Monitored productivity and ensured monthly targets were reached
• Trained support staff, engaged in knowledge sharing and participated in new staff orientation
• Monitored and followed up on queries escalated to the development team
• Coordinated and conducted testing of the system
• Created a high-quality work environment to motivate team members to perform to the best of their ability
• Streamlined and optimised processes where possible
• Drove investigations and ensure timeous resolution thereof.

• Assisted the Project Manager in planning and completing projects successfully
• Set up User Requirement and Business Requirement Specification documents
• Reviewed Technical Change Request documentation
• Planned, conducted and ran Project Pilot Plans and Project Roll out plans
• Conducted and reported on group test workshops
• Assisted with User Acceptance Testing (UAT)
• Weekly reporting to management
• Performed general administration and drove project deliverables in order to meet deadlines and ensure delivery within parameters.

• Provided leadership and guidance to support staff, assigned queries to support staff and followed up to ensure queries were attended to timeously
• Coordinated and drove monthly meetings with integrated companies
• Ensured that the support staff constantly followed up with medical practices, regarding the status and progress of their unresolved queries
• Provided telephonic support to staff to assist and guide external users on general and advanced use of all system functionalities
• Monitored inbound phone calls to ensure an excellent level of service delivery
• Identified training needs and communicated with relevant managers.

• Provided telephonic support and guidance to users of the VeriClaim system, ensuring to provide an exceptional customer service experience
• Reported practice related queries on the ticketing system and escalated tickets to the development team where necessary
• Actioned, investigated and resolved queries within turnaround times
• Attended to general departmental administration
• Assisted with testing after technical upgrades
• Tested tariffs after receiving annual tariff files from the medical aids
• Gained knowledge of ICD10 or Procedure coding.

• Processed all consignment orders and invoiced patients on behalf of clients
• Attended to customer queries and logged all relevant information
• Actioned, investigated and resolved queries and provided relevant feedback
• Assisted with general departmental customer care
• Processed orders for all consignment stock replacements
• Systematically managed all consignment accounts at various hospitals, ensuring that consignment and rep accounts balanced on a monthly basis
• Coordinated daily deliveries and collections from various hospitals
• Established and maintained strong customer or client relations.

• Engaged clients to professionally deal with queries and logged all relevant information on the ticketing system
• Actioned, investigated, and resolved queries and provided relevant feedback
• Processed telephonic and paper-based orders, ensuring the provision of exceptional customer and client care standards
• Ran monthly target reports and provided feedback to the relevant clients.

• Compiled quotations and processed and invoiced all orders
• Managed stock and coordinated the full inventory stock count
• Oversaw and managed daily deliveries and collections
• Managed consignment accounts at hospitals
• Assisted with departmental administration and general sales functions.