Zuziwe Happiness Mkhize
Medical Claims Administrator
Durban
Summary
Claims specialist with strong focus on resolving issues efficiently and delivering results. Adept at managing complex claims processes, analyzing data, and ensuring compliance with regulations. Known for excellent teamwork and adaptability in dynamic environments. Skilled in customer service, communication, and problem-solving, consistently contributing to organizational success.
Personable and detail-oriented professional with strong aptitude for managing complex information and resolving issues efficiently. Knowledge of claims processing and proficient in data analysis and customer service. Dedicated to ensuring accuracy and enhancing operational workflows.
Offering solid foundation in analytical thinking and problem-solving, eager to learn and excel in claims administration. Brings ability to understand and apply industry-specific regulations and policies. Ready to use and develop skills in data management and customer service in Claims Administrator role.
Overview
15
15
years of professional experience
2008
2008
years of post-secondary education
4
4
Certifications
3
3
Languages
Work History
PA / Medical Claims Administrator
DR S SIMANGO TRADING ENTERPRISE
03.2012 - Current
- Company Overview: ST AUGUSTINE’S HOSPITAL
- Debt collecting, data capturing, compiling reports – Medico-legal, medical reports, RAF1 & 4
- COID/WCA, FEMA, Ethekwini Municipality, compeasy system/ umehluko, COID Gazette Knowledge, (WCL4, WCL2,WCL5), Letter of good standing,RMA, SAPS, ICD10 coding, Procedure codes, sending claims electronically – switch com + using Medemass
- Practice Manager for 1 year
- Theatre slate/ list bookings, medical aid accounts, petty cash, Invoicing patients, gap cover, reprocessing under prescribed Minimum Benefits (PMB), claims queries, affidavits, practice Travelling, accommodation bookings, scheduling meetings, Liaising with key stakeholders: Reps, patient’s, different Dr’s and the hospital staff
- Manage Dr’s diary
- Render effective filing and record management
- Authorizations, Remittance and registered mail
- Laminating & document binding
- ST AUGUSTINE’S HOSPITAL
Admin Clerk – Parklands Hospital
DR AB CHIKOSI
11.2010 - 02.2012
- Company Overview: GYNAECOLOGIST
- Data capturing, processing of information to the computer
- Doing medical aid accounts and sending them electronically using healthbridge software
- Dealing with incoming and outgoing calls as well as theatre bookings and authorizations
- Booking beds for patients
- Handling cash payments
- General admin work
- Maintaining appropriate filing System and records and sterilizing pap smear tools
- GYNAECOLOGIST
- Reason for leaving: Dr closed rooms at Parklands
Receptionist
LIVE SMART
12.2009 - 10.2010
- Data processing of information to the computer
- Carrying out general office duties EG: answering the telephone, attending to clients And liaising with them regarding their queries
- Scheduling client appointments, customer service
- Selling products and petty cash handling
- Reason for leaving: Retrenched
Education
Senior Certificate (Matric) - Math Literacy, Life Science, Accounting, English, Life Orientation, Physical Science, Afrikaans
Futura High School
Skills
Excellent communication
Interpersonal skills
Written skills
Management skills
Problem-solving skills
Good understanding of public service
Understanding of procedures (Batho Pele)
Medical Terminology
Ability to work independently
Ability to work without supervision
Understanding towards patients
Empathy towards patients
Ability to stay calm under pressure
Flexibility
Honesty
Loyalty
Ability to work extra hours
Information verification
Customer communication
Skillsandpersonalattributes
- Excellent communication, interpersonal and written skills
- Management and problem-solving skills
- Good understanding of public service and procedures (Batho Pele)
- Medical Terminology
- Ability to work independently with or without supervision
- Understanding and empathy towards patients that need care
- Ability to stay calm under pressure
- Flexibility, honest and loyal
- Able to work extra hours if needed
Firstnames
Zuziwe Happiness
Personal Information
- ID Number: 891223 0886 085
- Date of Birth: 12/23/89
- Nationality: South African
- Marital Status: Single
Certification
Secretarial
Timeline
PA / Medical Claims Administrator
DR S SIMANGO TRADING ENTERPRISE
03.2012 - Current
Admin Clerk – Parklands Hospital
DR AB CHIKOSI
11.2010 - 02.2012
Receptionist
LIVE SMART
12.2009 - 10.2010
Senior Certificate (Matric) - Math Literacy, Life Science, Accounting, English, Life Orientation, Physical Science, Afrikaans
Futura High School