Jirra
Mirranda Dlamini
Johannesburg
Summary
Organized, reliable and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to act as a company's role model and take on added responsibilities to meet team goals and providing excellent service.
Overview
13
13
years of professional experience
1
1
Language
Work History
Customer Service Representative
Aegis Global
Johannesburg
02.2022 - 09.2022
- Responded to customer inquiries and provided excellent customer service via phone, email, and chats.
- Addressing and resolving concerns and providing product information promptly and courteously to the UK clients.
- Collaborated with senior team members to resolve complex issues, ensuring customer satisfaction and retention.
- Documented interactions in the company’s CRM system, maintaining accurate and organized records.
- Assisted in creating and updating knowledge base articles/SOPs, contributing to improved self-service options for customers.
- Maintained customer satisfaction with forward-thinking strategies.
- Sought ways to improve processes and services provided.
- Responded proactively and positively to rapid change.
- Met customer call guidelines for service levels, handle time and productivity.
- Answered constant flow of customer calls with minimal wait times.
- Updated account information to maintain customer records.
Team Leader Coach
Discovery Health
Johannesburg, South Africa
02.2019 - 03.2021
- Communicated KPIs outlined in annual plan to inform employees of expectations and deliverables.
- Enhanced team productivity by implementing efficient work processes and regularly reviewing performance metrics.
- Maintained database systems to track and analyze operational data.
- Monitored time and attendance, enforcing compliance with company procedures relating to absenteeism.
- Led cross-functional teams to execute projects on time, within budget, and with high-quality outcomes.
- Evaluated team member performance against established objectives during regular reviews, offering praise for achievements or identifying areas requiring further development.
- Assisted in recruitment of new team members, hiring highest qualified to build team of top performers.
- Conducted training and mentored team members to promote productivity and commitment to friendly service.
- Developed team members'' skills through targeted coaching sessions, resulting in improved individual performance.
- Provided reporting for forecast analysis and ad-hoc reporting in support of decision-making.
- Managed leave requests and absences and arranged covers to facilitate smooth flow of operations.
- Collaborated with other department leaders to establish shared goals and ensure alignment across teams.
Medical Claims Specialist
Discovery Health
Johannesburg, South Africa
02.2016 - 01.2019
- Reviewed provider coding information to report services and verify correctness.
- Identified opportunities for cost savings by analyzing medical billing patterns across various departments.
- Effectively resolved claim disputes by conducting thorough investigations and presenting findings to stakeholders clearly and concisely.
- Verified patient insurance coverage and benefits for medical claims.
- Optimized workflow processes by identifying bottlenecks within the system, implementing necessary changes for increased efficiency.
- Processed insurance payments and maintained accurate documentation of payments.
- Developed strong relationships with healthcare providers to facilitate efficient information exchange regarding patient eligibility and benefits coverage.
- Identified and resolved discrepancies between patient information and claims data.
- Monitored outstanding accounts receivable balances for trends that could indicate payer issues or potential collection problems.
- Managed large volume of medical claims on daily basis.
- Maintained confidentiality of patient finances, records, and health statuses.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Paid or denied medical claims based upon established claims processing criteria.
- Generated reports on medical claims processing activities and results.
- Assessed medical claims for compliance with regulations and corrected discrepancies.
- Utilized advanced knowledge of ICD-10 codes to accurately process complex medical claims.
- Worked effectively in fast-paced environments.
- Learned and adapted quickly to new technology and software applications.
Medical Claims Assessor
Discovery Health
Johannesburg, South Africa
04.2011 - 01.2016
- Assessed medical claims for compliance with regulations and corrected discrepancies.
- Followed up on denied claims to verify timely patient payment and resolution.
- Paid or denied medical claims based upon established claims processing criteria.
- Reviewed provider coding information to report services and verify correctness.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Maintained a high level of customer satisfaction by promptly addressing inquiries and resolving issues related to medical claims.
Office Administrator
Discovery Health
Johannesburg, South Africa
06.2009 - 03.2011
- Demonstrated exceptional multitasking abilities while juggling diverse responsibilities, including reception duties and ad-hoc administrative tasks.
- Contributed to a positive work environment by fostering strong working relationships among colleagues.
- Expedited invoice processing by accurately reviewing vendor submissions, reconciling accounts payable discrepancies, and conducting timely payments.
- Safeguarded company information by maintaining strict confidentiality protocols and ensuring secure document storage practices.
- Reconciled account files and produced monthly reports.
- Maintained electronic and paper filing systems for easy retrieval of information.
- Scheduled conference rooms, prepared agendas, and maintained calendars to prepare for meetings and events.
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Assisted in event planning efforts for company gatherings, conferences, or workshops to enhance employee engagement and networking opportunities.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Developed strong organizational and communication skills through coursework and volunteer activities.
Education
Bachelor Of Science In Management Accounting -
NQF Level 4 Certificate In Medical Claims Assessin - Medical Claims Examination
10.2008
Matriculation - High School Diploma
12.2006
Skills
Account Reconciliation
Accomplishments
- Supervised team of 18 staff members.
- Best performer award within first 6 months of being a customer service representative.
- Most inspirational Leader in 2020
- Always reaching and exceeding targets and SLAs as a Team and Individual
- Received Star Award and Dazzling Award for always going an extra mile in resolving escalationsand a Team Leader and Specialist.
- Saved the company R500 000 by identifying a fraudulent claim as an Assessor in 2013
Additional Information
References: Available upon request
Work Preference
Work Type
Full TimePart TimeContract WorkWork Location
RemoteOn-SiteHybridImportant To Me
Work-life balanceCareer advancementFlexible work hoursWork from home optionCompany CultureSoftware
Google workspace
Interests
AI revolution
Technology
Crypto currency
Affiliate Marketing
Virtual Assistance
Teaching English online
Content creation
Digital Marketing
Social Media Management
Timeline
Customer Service Representative - Aegis Global
02.2022 - 09.2022
Team Leader Coach - Discovery Health
02.2019 - 03.2021
Medical Claims Specialist - Discovery Health
02.2016 - 01.2019
Medical Claims Assessor - Discovery Health
04.2011 - 01.2016
Office Administrator - Discovery Health
06.2009 - 03.2011
University of South Africa - Bachelor Of Science In Management Accounting ,
Discovery Institute - NQF Level 4 Certificate In Medical Claims Assessin, Medical Claims Examination
Matomela - Matriculation , High School Diploma
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