Manager Information Technology

Location:

Kempton Park, GP, South Africa

Posted:

October 19, 2017

Contact this candidate

Resume:

Curriculum Vitae of Nombulelo Vice

PERSONAL DETAILS:

Name : Nombulelo

Surname : Vice

Date of Birth : 1985-04-15

Identity Number : 850-***-**** 085

Nationality : South African

Sex : Female

Marital Status : Single

Driver's license : Learners license code(8)

Home Language : Isixhosa

Other Languages : English, IsiZulu and Afrikaans

Residential & Postal Address : 1 Whisken Avenue. 23 Crowthrone Village Carlswald, Midrand. 1685

Contact Details : 083-***-**** © or *********.****@*****.*** (e) ACADEMIC DETAILS:

1. Name of Institution : Cape Peninsula University of Technology (CPUT) Name of Qualification : Btech: Public Management

Completion date : 2011

2. Name of Institution : Cape Peninsula University of Technology (CPUT) Name of Qualification : National Diploma: Public Management Completion date : 2010

3. Name of Institution : State Information Technology Agency (SITA) Name of Qualification : Certificate: Contact Centre Support Completion date : 2011

SECONDARY EDUCATION:

Last School Attended : Nkululeko Secondary School

Year Matriculated : 2005

Subjects : IsiXhosa; English; Afrikaans; Business Economics; Economics; Biblical Studies

WORKING EXPERIENCE:

1. Name of Company : Metropolitan Health (MH) – GEMS Business Unit Position Held : Correspondence Agent

Duration : 01 January 2016 till 30 September 2016

Reason for leaving : Resigned

Duties include but not limited to:

• Dealing with medical aid claims related enquiries (payments, and reprocessing unpaid or short paid claims according to Scheme Rules).

• Dealing with MVA/RAF/Third Party enquiries, claims and complaints from attorneys on behalf of GEMS members.

• Responding to clients enquiries telephonically, and in writing.

• Ensuring that the organisations achieves Service Level Agreement (SLA).

• Dealing with outgoing and incoming correspondence (via email, fax and post) regarding claims, benefits, financial inquiries, and complaints.

• Maintaining confidentiality of staff and customer information.

• Dealing with outgoing and incoming calls from Members and Practice regarding claims and benefits.

• First response resolution via written communication for resolving member queries to member satisfaction.

• Ensuring that quality standards are met at all times.

• Ensuring the Scheme and, in particular, MH are not unnecessarily exposed to financial risk as a result of incorrect confirmation of benefit-, claims-, or membership- information.

• Submitting daily and monthly stats as required by management. 2. Name of Company : Metropolitan Health (MH) – Bankmed Business Unit Position Held : Claims Assessor

Duration : 01 February 2015 till 31 December 2015

Reason for leaving : Contract ended

Duties include but not limited to:

• Processing of all incoming claims within SLA - Processing of claims according to predetermined standard & rules quality control computer.

• Knowledge of the NHRPL – national health reference price list thorough knowledge of the MHG claims operating system ability to interpret & apply scheme rules correctly processing electronic data interchange claims EDI.

• Claims assessing and Validations - Ensure effective claim validations using standard checklists. Ensure successful claims assessment and decision making through effective judgement of evidence received (Medical, Occupational and Financial).

• Successfully manage non-disclosures/Anti Selection/Fraud utilising best practice guidelines and report back findings to relevant departments. Research, present and action feedback in the Claims Committee meetings. Manage long term claims on an on-going basis.

• Service Excellence - Maintain service excellence to client portfolio through adhering to turn around times of claims according to the nature of the claim; maintain professional service levels in line with client expectations; SLA’s and TCF.

• Claims Escalations - Ensure claims that need to be escalated further are done so in an appropriate and timeous manner.

• Claims Administration - Communicate to internal and external stakeholders on set requirements, payment letters, decision letters and progress. Capture all information of claims on software according to checklist. Referral to re-insurance on claims within referral limits.

• Payments - Payments of all valid claims accurately and timeously. Ensure effective payment management and review of on-going claims.

3. Name of Company : Phanda Personnel Recruitment (Agency) Position Held : Recruitment Administrator

Duration : 04 January 2012 till 30 January 2013

Reason for leaving : Contract expired

Duties include but not limited to:

• Maintain a record system and archive.

• Render the administrative and processing of new clients.

• Record daily statistics of new recruits on spread sheet.

• Deal with written and telephonic queries of clients.

• Maintain the administration of the office.

• Attend to correspondence (mail, telephone calls, faxes, photocopy of documents).

• Type and edit correspondence and reports.

• Conduct research for suitable candidates.

• Typing & submitting VCs to the clients.

• Conducting interviews and placements.

• Conduct search for suitable candidates.

4. Name of Company : South African Breweries (SAB) Ltd Position Held : Assistant License Specialist(admin clerk) Duration : 15 April 2013 till 30 April 2014

Reason for leaving : Contract expired

Duties included but not limited to:

• General administration

• Capturing client data on computer

• Facilitate Liquor License Application Process.

• Build and Maintain Stakeholder Relations.

• Administer and Maintain Clients Data Base.

• Administrative and processing of new clients.

• Submitting documents to the Liquor Board.

• Dealing with written and telephonic queries of clients. REFERENCES:

Name : Mr Lizwi Makuliwe

Position : Team Leader

Name of Company : Metropolitan Health (MH) – Bankmed and GEMS Business Unit

Name : Mrs Solani Lidzade

Position : Manager

Name of Company : Phanda Personnel Recruitment (Agency) Contact Details : 083-***-**** © or 021-***-**** (w) Name : Mrs Zukiswa Gaqavu

Position : Manager

Contact this candidate