Valerie Mashigo

**** ****** **** *** *, Soweto, *819

Landline: 073-**-***** adp9c5@r.postjobfree.com Mobile: 083-******* Good Day,

Kindly find attached resume for the position advertised. My background of studying has given me Three years extensive vocation work experience as a claims technician in short term insurance for hospital cash back policies, making me very knowledgeable in medical terminology, identifying problems and ICD 10 coding.

In reviewing my CV you will establish that I have varied skills and ability to work with different types of people, I have excellent telephonic etiquette and communication skills and I believe I could fit easily into a team. I am a conscience person who is hard working and pays attention to detail, I am flexible and a team player, quick to pick up new skills and eager to learn from others. I am keen and enthusiastic to work for a company that a great reputation and high profile. Please take the time to read my resume which I believe you will find more than suitable for this role, I have excellent references and would be delighted to discuss any other possible vacancy with you at your convenience. I would also be grateful if you keep my CV on your database for any future possibilities.

Should you require any further information please do not hesitate to contact me. Kind Regards;

Valerie Mashigo

Enclosed: Resume

Valerie Mashigo Resume

Personal Details

Cell phone Number : 083*******

Home Number : 073*******

Email Address : adp9c5@r.postjobfree.com

Home Address : 5595 Protea Glen Ext 4

Soweto

1819

Nationality : South African (ID: 720**********)

Age : 45 (23th September 1972)

EE/AA Status : African Female

Career Summary

Company Position Duration

IFM Regional Medical Aid Customer Services Consultant October 1996-May 1999 Fedsure Health Group Customer Services Consultant June 2000-June 2001 Bensure Medical Aid Customer Services Consultant July 2001 to July 2002 MX Group Customer Services Consultant July 2002-July 2005 Metropolitan Health Group Customer Services Consultant November 2005-June 2006 Life Healthcare Group Filing, checking on once off payment July 2006-November 2006

Old Mutual Healthcare Customer Services Consultant January 2007 -february2009 Total Facilities Management

Company (TFMC)

Customer care May 2010 -October 2010

FNB Life Insurance Call Center Agent Jan 2011 - 30 August 2011 All Life insurance Underwriting 01 September 2011 - 31 January 2012

Prime Meridian direct Claim technician 02 February 2012 to December2016 Dr KJ Tlale Medical receptionist From 01 September 2017 to present

Employment

October 1996-may 1999 IFM Regional Medical Aid

Customer Services Consultant

Handling ambulance accounts

Logging and validating service providers’ accounts

Processing of claims

Reason for Leaving: To expand on my knowledge and to learn new skills and to also impart the knowledge that I have on to others

June 2000-June 2001 Fedsure Health Group

Redirecting calls to appropriate departments / medical aid schemes

Handling membership issues – registrations and terminations

Helping members and practices with medical claims

Making sure that accounts are paid promptly and accurately

Query resolutions from point of contact to conclusion.

Advising members on which options are suitable for them

Member education on how the medical aid industry operates.

Ensuring the smooth processing of medical accounts

(accurate referrals)

Liaising with different departments to ensure quality service.

Assisting members with financial issues like monthly contributions

Changing and updating of bank details and contact details

Capturing queries on Medware (in house system)

Checking the status of accounts on the Medware system

Doing call-backs on behalf of management / customer service

Assisting at the walk in centre (dealing with clients on a face to face basis)

Assisting with the training and induction of new employees to help them learn more about the industry.

Benefit confirmations.

Issuing of cheques to service providers

Reason for Leaving: Better prospects

July 2001 to July 2002 Bensure Medical Aid

Redirecting calls to appropriate departments / medical aid schemes

Handling membership issues – registrations and terminations

Helping members and practices with medical claims

Making sure that accounts are paid promptly and accurately

Query resolutions from point of contact to conclusion.

Advising members on which options are suitable for them

Member education on how the medical aid industry operates.

Ensuring the smooth processing of medical accounts (accurate referrals)

Liaising with different departments to ensure quality service.

Assisting members with financial issues like monthly contributions

Changing and updating of bank details and contact details

Doing call-backs on behalf of management / customer service

Assisting at the walk in centre (dealing with clients on a face to face basis)

Assisting with the training and induction of new employees to help them learn more about the industry.

Benefit confirmations.

Reason for Leaving: Not enough room for growth

July 2002-July 2005 MX Group Medical Aid

Processing chronic benefits applications

Sending remittances to service providers

Handling membership issues – registrations and terminations

Helping members and practices with medical claims

Making sure that accounts are paid promptly and accurately

Query resolutions from point of contact to conclusion.

Advising members on which options are suitable for them

Member education on how the medical aid industry operates.

Ensuring the smooth processing of medical accounts (accurate referrals)

Liaising with different departments to ensure quality service.

Assisting members with financial issues like monthly contributions

Changing and updating of bank details and contact details

Capturing queries on an in house systems

Checking the status of accounts on the system

Reason for Leaving: Not enough room for growth

November 2005-June 2006 Metropolitan Health Group

Benefit confirmations to service providers

Pre assessing accounts

Assessing of claims

Account enquiries

Making sure that accounts are paid promptly and accurately

Query resolutions from point of contact to conclusion.

Ensuring the smooth processing of medical accounts (accurate referrals)

Liaising with different departments to ensure quality service Reason for Leaving: Not enough room for growth

July 2006-November 2006 Life Healthcare Group

Filing, checking on once off payment

Doing call-backs on behalf of management / customer service

Processing of invoices

Sending of remittances to service providers

Query resolutions from point of contact to conclusion

Checking if new hospitals goods are received

Payment if is received

Reason for Leaving: Not enough room for growth

January 2007 –February 2009 Old Mutual Healthcare

Redirecting calls to appropriate departments / medical aid schemes

Handling membership issues – registrations and terminations

Helping members and practices with medical claims

Making sure that accounts are paid promptly and accurately

Query resolutions from point of contact to conclusion.

Advising members on which options are suitable for them

Member education on how the medical aid industry operates.

Ensuring the smooth processing of medical accounts (accurate referrals)

Liaising with different departments to ensure quality service.

Assisting members with financial issues like monthly contributions

Changing and updating of bank details and contact details

Capturing queries on system

Reason for Leaving: To expand on my knowledge and to learn new skills and to also impart the knowledge that I have on to others

May 2010 -October 2010 Total Facilities Management Company (TFMC)

Logging of customer requests

Conveying follow ups on

Previously logged requests

Handling of dispatches

For all applicable region

Updating the complaint report

Updating the VIP reports

Customer’s survey

Reason for Leaving: To expand on my knowledge and to learn new skills and to also impart the knowledge that I have on to others

Jan 2011 - to 30 August 2011 FNB Life Insurance

Update on funeral cover

Adding, deleting dependents

Redirecting calls to appropriate departments

Making sure that accounts are paid promptly and accurately

Query resolutions from point of contact to conclusion.

Advising members on which options are suitable for them.

Knowledge of short term insurance

Reason for leaving To expand on my knowledge and to learn new skills and to also impart the knowledge that I have on to others

01 September 2011 - to 31 January 2012 All Life insurance

Responsible for underwriting life, disability, dread diseases, sickness and permanent incapacity cover.

Underwrite cases within the agreed sla

Assess and authorize cases within underwriting to ensure accurate financial underwriting decision.

Sent to reinsurance treaties and placement authorities

Examine document to determine of health risk from such factors as health.

Review medical records to determine amount of insurance in force on single risk

Write medical personnel and others to obtain information, medical history explain company underwriting policies

Request pma reports from doctors

Have knowledge of short term and long term insurance Reason for leaving To expand on my knowledge and to learn new skills and to also impart the knowledge that I have on to others

02 February 2012- to December 2016 Prime Meridian direct

Handling either personal or commercial claims

Including injuries, accident, death claims

Liaising with insured party

Instructing loss adjusters/claim investigators

Ensuring a fair settlement for the client in the event of a claim

Communicating with both sides to insure that the client is Good service

Good service

Advising clients on insurance issues in general

Requesting hospital files, requesting reports from doctors

Liaising with medical aid

Assessing of claim, including motivation letter

Review of all information submitted in support of the claim against the applicable policy Terms & Conditions of cover.

Responsible for investigating and resolving all death and hospital assigned claims

Assess the claim duration of the admission, treatment given, test results, cause of admission and final diagnosis in order to validate the claim.

Ensuring claims are assessed in accordance to Company Standards for quality and service and ability to excel under pressure

Ensuring turnaround times are adhered to

Sturdy telephone etiquette and attention to detail

Requesting hospital files, requesting reports from doctors and good letter writing ability

Regular interactions with claimant to update them on the progress and outcome of their claims.

Reason for Leaving: Better prospects

01 september2017- to present Dr KJ Tlale

Answering of phones

Leasing with medical aids

Booking of patients

Attending to queries

Appointment confirmation with patients

Managing dairy and opening files

Maintaining files

Emailing and faxing reports

Data capture

Obtaining authorization from medical aid, confirm benefits

Booking theater lists

billings

Cash payments collecting outstanding payments

Experience with vericlaim system

Education

National Diploma Damelin (1996 -1997)

Communication 1

Statistics

Marketing Management

Accounting

Management

The community chest west rand (1998-1998)

Secretarial Certificate

Life Line Counseling Centre (2007)

Counsellor

Trauma Counseling

HIV and Aids issues

Rape, Abuse

Face To Face Counselling

Masentle High School (1993) (Lesotho)

English Language (B)

Sesotho (D)

Biology (B)

Commercial Studies (E)

Mathematics (B)

Biblical Studies (D)

References

Ms Eulanda Nkomo

012-***-****/082*******

Ms Diane Howell

011*******

Ms Annamarie Schoemann

Tel: 011*******

Ms Margie Ketho

Tel: 011******* Cell: 083292446

Mr Francois Brand

Tel: 011-******* ext 2171

Cell: 083*******

Ms Nicky Nicholson

Tel: 011-***-****

Johan Erwee (Claims Manager)

Cell: 079-***-****

Computer Literacy

Microsoft Office: MS Word, Excel, PowerPoint, Outlook, Internet Knowledge of in-house systems

Oracle system, IMED system, new med system, Medware and Sap system, ski, magnum, genre clue, Vertigo system.

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