Melissa Telemachus
Summary
Detail-oriented Case Manager skilled in administrative coordination and medical aid liaison. Manages patient records and billing processes, ensuring compliance with data protection regulations. Delivers precise reporting and auditing of patient files, supporting operational effectiveness.
Overview
2
2
Languages
17
17
years of professional experience
Work History
Case Manager / Admin Manager
Optima@Rustenvrede Hospital
Stellenbosch, South africa
06.2018 - Current
- Maintained accurate and confidential client records, adhering to data protection regulations.
- Coordinated with medical aid companies to facilitate patient claims and resolve discrepancies.
- Submitting claims
- Reviewing claims
- Forllow up on claims/payments
- Handling correction on claims and reprocessing
- Processed patient admissions and discharges in a timely manner.
- Processed pharmacy and ward stay billing to ensure timely reimbursement.
- Debt collection
- Handling of accounts
- Organised and maintained patient files systematically.
- Auditing of patient files
- Record keeping of information
- Compiled and submitted statistics to assist in operational decision-making.
- Bedlist allocation and preparation
- Notifications of discharge
- Submitting progress reports
- Bedlist reports ,Shift reports
- Supervising staff /Office
Receptionist Administrator
Mediclinic
Stellenbosch, South africa
03.2009 - 05.2018
- Coordinated administrative tasks to ensure smooth operations
- Liaising with medical aid companies
- Pre-admissions,updates of bookings
- Admission, discharges of patients
- Scheduled and confirmed bed availability for optimal patient flow
- Organised operating theatre timings for surgeries to enhance procedural efficiency
- Icd 10 coding and cpt coding
- Filing of patients test results
- Filing ,banking and receipting
- Pharmacy billing
- Processing direct deposits
Education
Certificate of Higher Education - Matric
Cloetesville High
Stellenbosch, WC01-2003
Skills
- Claims management
- Medical aid liaison
- Billing
- Patient Financial Management
- Financial Reporting
- Medemass software
- QuickBooks
- MS Office , Excel
- AS/400
- Administrative coordination
- Staff supervision
- Patient interaction
- Medical confidentiality
- Daily end-of-day reports
Languages
Afrikaans
Advanced
C1
English
Advanced
C1
Timeline
Case Manager / Admin Manager
Optima@Rustenvrede Hospital
06.2018 - Current
Receptionist Administrator
Mediclinic
03.2009 - 05.2018
Certificate of Higher Education - Matric
Cloetesville High