Mmaphuthi Sipai
Medical Claims Handler
Theresa Park
Summary
- Seeking a challenging position in a field where I can utilize my experience to contribute to the success of the company, To secure a role in dynamic company that offer the opportunities for professional growth.
Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.
Overview
15
15
years of professional experience
1
1
year of post-secondary education
3
3
Languages
Work History
WCA Claim Validator
Coidlink
12.2009 - Current
- Managing of my allocated production line Quality control of all work outputs of scanned info, captured information detail and billing
- Excellent knowledge of COIDA act, medical anatomy and all discipline as per government gazetted tariffs
- Assessment of billed invoices Process of payment according to the gazetted tariffs per discipline
- Extended knowledge on all disciplines rules and modifiers and application
- Reduced errors in data entry by implementing comprehensive validation checks and procedures.
- Enhanced data quality through thorough examination of records, ensuring the integrity of information used in decision-making processes.
- Reversals on payments
- Client queries and communications
- Training of new staff members
- Managed a team of junior validators, providing guidance on best practices and overseeing their work to maintain high levels of accuracy across all projects they were involved in.
- Managing crisis control on backlogs
- OHS representative duties, Identify health hazards and take measures to avoid any incidents
Education
Certificate - Health Administration
Mancosa
Gauteng, Centurion High School Diploma -
Batloung Secondary School
Mafikeng 04.2001 - 05.2002
Skills
Customer service
Planning
Organizing
Self motivated
Accuracy and Precision
Cross-functional coordination
Effective Communication
Teamwork and Collaboration
Problem-solving abilities
Relationship Building
Personal Information
- Date of Birth: 09/18/84
- Gender: Female
- Nationality: South Africa
- Driving License: Code 8
References
Issavani Pillay, Coidlink, Line Manager, 0723956413
Achievementsandawards
- ILearn, Introduction to Excel and Excel intermediate program
- Savant, Unleashing Potential Customer service
- First Aid Training SA, Basic SHE Rep
- Health Risk Management and Medical coding Specialist, Introduction to Basic ICD-10 coding
- Basic anatomy and physiology
Timeline
WCA Claim Validator
Coidlink
12.2009 - Current
High School Diploma -
Batloung Secondary School
04.2001 - 05.2002
Certificate - Health Administration
Mancosa