Summary
Overview
Work History
Education
Skills
Certification
Timeline
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Mmama Maria Baloyi

Pretoria,GP

Summary

Dynamic and detail-oriented professional with extensive experience at Pretoria Eye Institute, excelling in patient-centered support and effective communication. Proven ability in healthcare billing protocols and adept at critical thinking, ensuring seamless operations and enhanced patient satisfaction. Skilled in managing complex administrative tasks while maintaining organized records and fostering collaboration among healthcare teams.

Overview

18
18
years of professional experience
1
1
Certification

Work History

Ophthalmic Assistant/ Admissions Clerk

Pretoria Eye Institute
08.2017 - Current
  • Switchboard handling and appointment scheduling.
  • History taking and opening of files.
  • Specialized imaging.
  • Assisting specialists with in-rooms procedures.
  • Equipment and stock management.
  • Liaison with doctors and technicians to ensure effective practice management.
  • Provide patient centered admin support.
  • Admissions and discharge of patients.
  • Pre-admissions, coding and auditing of files.
  • Cash handling and receipting.
  • Confirmations.
  • Billing of theatre stock.

Call Center Agent

Medscheme
01.2016 - 07.2017
  • Address queries from members regarding their oncology benefits, treatment authorizations, and related administrative processes.
  • Communicate with healthcare providers and specialists to gather necessary information or confirm details for oncology treatments.
  • Update member accounts, process claims information, and ensure all relevant details are correctly logged in the system.
  • Proactively identify and resolve issues and concerns faced by members and providers within the scope of their benefits and services.
  • Working with other departments to ensure a seamless workflow and assist the front-office team when necessary.
  • Maintaining organized and up-to-date records, including loading, updating, and cancelling contracts.
  • Managing and escalating queries from fund management and other departments, ensuring prompt resolution within established service level agreements (SLAs).

Non-Clinical Call Centre Agent

MMI Holdings
05.2015 - 12.2015
  • Receive and evaluate applications for pre-authorizations.
  • Confirm membership status and benefits.
  • Approve benefits in line with protocols and benefits options.
  • Perform clinical risk assessments and escalate cases to case management.
  • Respond to inquiries from members and service providers.
  • Keep accurate records of transactions and documentations.
  • Stay updated scheme rules, benefit options and legislation.

Reception Administrator

Mediclinic Kloof
03.2008 - 04.2015
  • Handling switchboards by transferring calls to relevant departments.
  • Pre-admission of patient files.
  • Coding and auditing of files.
  • Liaison with medical aids for hospital authorizations.
  • Cash handling and receipting.
  • Coding files for billing purposes.
  • Confirmations.

Education

No Degree - Grade 12

Rakgotso High School
Hammanskraal, South Africa
12-2003

Skills

  • Communication Skills
  • Ms Office( Word, Excel, PowerPoint, Outlook)
  • Goodx, AS400, UMS, NOC
  • Critical thinking and problem solving
  • Adaptability
  • Telephone etiquette
  • Time management Skills
  • Good organizational and planning skills
  • Anatomy and medical terminology
  • Medical Aid Tariff Application
  • Proficient in healthcare billing protocols

Certification

  • COA - Certified Ophthalmic Assistant

Timeline

Ophthalmic Assistant/ Admissions Clerk

Pretoria Eye Institute
08.2017 - Current

Call Center Agent

Medscheme
01.2016 - 07.2017

Non-Clinical Call Centre Agent

MMI Holdings
05.2015 - 12.2015

Reception Administrator

Mediclinic Kloof
03.2008 - 04.2015

No Degree - Grade 12

Rakgotso High School

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Mmama Maria Baloyi