Sonia Kotze
Porterville
Summary
Dr Sonia Kotze
7806190075088
I am writing to express my interest in joining your clinical risk management team as a Dental Advisor of Clinical Claims Auditor. With 23 years of comprehensive private practice experience in dentistry, I want to transition into corporate managed healthcare. I want to bring my extensive clinical insights to your remote operations in the Western Cape.
I have diagnosed, treated and managed virtually every clinical scenario in dental medicine. This depth of experience gives me an intuitive, comprehensive understanding of dental billing patterns, treatment lifecycles and clinical justifications. While junior clinicians can review basic codes, my long career allows me to easily spot billing anomalies, over-servicing, and unauthorised treatment.
I have an uninterrupted, dedicated home office with fully independent backup power and sufficient internet connectivity to ensure full compliance with your operational uptime requirements. I am also willing to travel if necessary to fulfill all my work requirements. I am fully equipped to operate independently and efficiently. I am also immediately available and looking for a new challenge to use my dental expertise to the fullest.
I welcome the opportunity to discuss how my 23 years of clinical experience can strengthen your risk management and claims auditing teams.
Overview
22
22
years of professional experience
Work History
Dentist, Practice Management
Dr Luzelle van Wyk Private Practice
PORTERVILLE, Western Cape
01.2020 - Current
- Managed and led all clinical and financial aspects of a busy dental practice overseeing patient cases and complex treatment plans.
- Clinical Case Management: Mastered full-scope dental medicine, including maxillofacial, especially orthodontic, periodontal, endodontic and prosthodontic treatments-providing exact clinical intuition needed to audit complex corporate claims as well as finding alternative treatment if necessary.
- Clinical Risk Management: Evaluating high-volume, specialised dental claims against scheme rules.
- Financial oversight & billing compliance: Managed practice billing audits, resolved rejected claims, tracked coding compliance, and interpreted South African dental procedure codes, ICD-10 diagnostic mapping, and Prescribed Minimum Benefits (PMBs) to maintain transparent billing framework.
- Quality assurance & risk mitigation: Reviewed patient files, radiographic data, and clinical notes to ensure compliance with HPCSA guidelines and achieve optimal patient outcomes.
- Medical scheme liaison: Directed medical aid pre-authorisations and clinical motivations while navigating managed care rules across South African medical schemes.
Principle Dentist
Self-employed
Porterville, Western Cape
01.2008 - 07.2017
Locum Dentist
Dr Sarembock
Cape Town
01.2006 - 12.2007
Community Dentist
Department of Health
Ceres
01.2004 - 12.2005
Education
B.Ch.D Dentistry - Dentistry
University of Stellenbosch
Stellenbosch, WC2003
Skills
- Full spectrum of Dental procedures
- Clinical case management
- Treatment planning
- Clinical risk assessment
- Quality assurance
- Clinical risk management
- Compliance auditing
- Procedure documentation
- Financial oversight
- Patient education
- Patient communication
- Clear communication
- Adaptive problem solving
- Client relationship management
- Dental policy refinement
Professional References
- Dr Luzelle van Wyk
Head of Private Practice Porterville
081 045 6482
* Rachel Daniels
Assistant and administrative employee
073 636 5684
* Hester Daniels
Oral Hygienist
074 203 5097
Timeline
Dentist, Practice Management
Dr Luzelle van Wyk Private Practice
01.2020 - Current
Principle Dentist
Self-employed
01.2008 - 07.2017
Locum Dentist
Dr Sarembock
01.2006 - 12.2007
Community Dentist
Department of Health
01.2004 - 12.2005
B.Ch.D Dentistry - Dentistry
University of Stellenbosch