Microsoft, excel, word and PowerPoint
Mbali Dian Tabete
Pharmaceutical Claims Administrator
Johannesburg
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
7
7
years of professional experience
10
10
years of post-secondary education
Work History
Pharmaceutical Claims Administrator
MSA Outsourcing Solutions
04.2024 - Current
- Balanced workload effectively, prioritizing tasks to ensure timely completion of all claim-related responsibilities.
- Conducted thorough investigations into potentially fraudulent claims, reducing company losses, in stolen drugs/medication.
- Investigated, evaluated and adjusted multi-line claims in accordance with standards and laws.
- Developed easy-to-understand reports for management, detailing key metrics and performance indicators of the claims department.
- Provided exceptional customer service during stressful situations involving lost Medication and drugs that need to be returned for refund.
- Negotiated settlements within approved authority limits to achieve fair outcomes for both customers and the company.
- Cultivated productive relationships with stakeholders, facilitating claims lifecycle.
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
- Train the medical staff on the system and the alerts that the facility may receive when ordering drugs.
- Train medical staff on how to save the facility money on the drugs ordered and provide substitutes for cheaper medication.
Online English Teacher
Classgap
06.2022 - 01.2024
- Supported students in developing social skills through structured activities and positive reinforcement techniques.
- Maintained accurate records of student performance data and communicated regularly with parents or guardians regarding progress updates, challenges faced, and plans for improvement.
- Enhanced learning experiences by incorporating specialized tools and resources tailored to the needs of special education students.
- Developed strong rapport with students, fostering a positive and supportive virtual classroom environment conducive to learning.
- Assisted in creating a safe and nurturing classroom environment that promoted emotional well-being and academic growth for all students.
- Provided ongoing support to students outside of class hours through email correspondence or video conference sessions as needed.
- Implemented behavior modification strategies, resulting in improved self-regulation and classroom participation among students.
- Incorporated diverse teaching strategies to accommodate various learning styles and engage all students in the material effectively.
- Collaborated with fellow teachers to develop innovative teaching methods and share best practices for online learning environments.
- Boosted student confidence through tailored feedback and individualized support in areas of improvement.
- Assisted students with goal-setting and provided guidance in developing personalized study plans for long-term success in English language proficiency.
Debit Collections Agent
Nimble Group
08.2021 - 01.2024
- Improved overall portfolio performance through consistent monitoring of accounts and proactive identification of potential issues.
- Enhanced client relationships by consistently maintaining clear communication and promptly addressing concerns.
- Recognized as a top performer within the team for consistently surpassing goals and maintaining high levels of client satisfaction.
- Increased productivity levels through efficient time management and prioritization of daily tasks.
- Collaborated with various departments to ensure accurate billing information and resolve any discrepancies promptly.
- Built rapport with customers by demonstrating understanding of their situation while seeking fair resolutions.
- Maximized revenue recovery through diligent research, verification of debtor information, and persistent contact efforts.
- Streamlined the collections process for increased efficiency with detailed record-keeping and timely followups.
- Achieved successful debt collection results by utilizing negotiation skills and developing customized payment plans.
- Contributed to a positive team atmosphere by providing support, sharing knowledge, and participating in departmental initiatives.
- Assisted in training new hires on department procedures, system navigation, and best practices for successful collections.
- Exceeded monthly targets consistently as a result of strong negotiation skills combined with effective account management strategies.
- Directed day-to-day collections functions.
- Generated and distributed monthly customer statements.
- Located customers with overdue accounts and solicited payment in compliance with fair debt collection practices.
Customer Service Consultant
Merchants Vodacom
09.2017 - 08.2021
- Developed strong relationships with clients by consistently exceeding expectations in handling requests or concerns.
- Handled high call volumes while maintaining a courteous and professional demeanor.
- Improved customer satisfaction by promptly addressing and resolving inquiries and concerns.
- Maintained comprehensive knowledge of product offerings and company policies through continuous learning initiatives such as workshops or webinars.
- Managed difficult situations with tact, diffusing tensions and achieving positive outcomes for all parties involved.
- Collaborated with team members to share best practices and improve overall performance within the department.
- Provided personalized assistance for customers, ensuring their needs were met efficiently and effectively.
- Managed customer escalations to senior staff or management when necessary, ensuring the appropriate level of attention was provided for a resolution.
- Identified upselling opportunities during interactions with customers, promoting additional products or services that resulted in increased revenue.
- Provided feedback on potential areas for improvement within the department based on personal experiences and observations.
- Assisted management in implementing new policies and procedures, leading to improved service quality across the department.
- Enhanced team communication through regular briefings, fostering a more cohesive working environment for better productivity levels.
- Mentored new hires, providing guidance and support throughout their training period for optimal effectiveness in their roles.
- Utilized CRM software to accurately track customer interactions, enabling quick access to relevant information during future calls.
- Troubleshot customer service issues with methodical approach, eliminating impossible quickly and focused on implementing relevant, actionable solutions.
Assisting Coach
Merchants Vodacom
09.2017 - 08.2021
- Developed strong relationships with players'' families to encourage support and involvement in their athletic growth.
- Promoted sportsmanship values among athletes, fostering a positive competitive atmosphere within the team environment.
- Improved team cohesion by organizing regular bonding activities and fostering a supportive environment.
- Collaborated with other coaches to share best practices, techniques, and insights for overall program improvement.
- Enhanced team performance by developing and implementing effective coaching strategies.
- Mentored assistant coaches to develop their leadership skills and improve their understanding of coaching strategies.
- Trained and mentored new coaches on fundamentals of coaching to apply best practices and strategies.
- Increased athlete''s skills development through individualized training plans based on each player''s strengths and weaknesses.
- Utilized various coaching models and techniques to maximize client success.
Education
Certification - Secretarial Studies And Office Administration
Believers Care Society
02.2016 - 01.2017
Grade 12 - Grade 12
Forest High School
01.2010 - 01.2015
Diploma - Human Resources Management
University of South Africa
01.2021 - Current
Skills
User Support
Community Engagement
Social media knowledge
De-Escalation Techniques
Policy Enforcement
Assertiveness
Cross-cultural awareness
Content Moderation
Strong empathy
Online Etiquette
Innovation and Creativity
Delegation and Supervision
Administrative Support
Mail Management
Meeting planning
Mail handling
Organizational Skills
Team Collaboration
Professionalism
Goal Setting
Billing and coding
Report Writing
Excel spreadsheets
Interpersonal Skills
Multitasking
Problem-Solving
Multitasking Abilities
Reliability
Self Motivation
Referances:
Nimble Group: Manager
Name: Brandell Michaels
Contacts: 0658477836
MSA Outsourcing Solutions
Name: Olivia Centane
Contacts:0660427997
Software
Timeline
Pharmaceutical Claims Administrator
MSA Outsourcing Solutions
04.2024 - Current
Online English Teacher
Classgap
06.2022 - 01.2024
Debit Collections Agent
Nimble Group
08.2021 - 01.2024
Diploma - Human Resources Management
University of South Africa
01.2021 - Current
Customer Service Consultant
Merchants Vodacom
09.2017 - 08.2021
Assisting Coach
Merchants Vodacom
09.2017 - 08.2021
Certification - Secretarial Studies And Office Administration
Believers Care Society
02.2016 - 01.2017
Grade 12 - Grade 12
Forest High School
01.2010 - 01.2015
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