Claims Processor Medical Billing
Resume:
Professional Profile
Mr Luyolo Wandile Warren Nyangintsimbi is a black African Male in possession of a National Diploma in Sport Management from Tshwane University of Technology, an Advanced Diploma in Applied Management from the Central University of Technology and currently studying for a Bachelor of Laws with the University of South Africa as well as a Post Graduate Diploma in Project Management in Project Management with the Central University of Technology. He further obtained the following short course certificates;
Excellent Customer Care
Labour Relations
Samtrac
Customer Care
Risk Management
Medical Billing and Coding
Medical Terminology
ICD10 Coding
Medical Impairment
Competency and Skills to offer an Organisation
Project management and strategy development and execution, project management, report writing facilitation and presentation and excellent organisational coordination.
Service Delivery Innovations – Able to champion new ways of delivering services that contribute to the improvement of organisational processes in order to achieve organisational goals.
Financial Management Skills – Able to assist the unit in utilising, manage, control and account on all resources whether financial or otherwise in terms of applicable legislation.
Technological Adeptness – Fully conversant with the following programmes; Microsoft Excel, Microsoft PowerPoint, Microsoft Outlook, Microsoft Word
Knowledge of Legislation – Constitution of the Republic of South Africa, Occupational Health and Safety Act, Act 85 of 1993, Unemployment Insurance Act and the Compensation for Occupational Injuries and Diseases Act, UI Contribution Act, Employment Equity Act, Labour Relations Act 66 of 1995, Basic Conditions of Employment Act 75 of 1997
Education
National Diploma Sport Management Tshwane University of Technology
ADVANCED DIPLOMA Applied MANAGEMENT
Central University of Technology
BACHELOR OF Laws (UNISA) in Progress (Final Semester)
Post Graduate Diploma in Project Management (Central University of Technology) in Progress
Passed Matric at Aliwal North High School 2002 (Exemption)
School subjects (Accounting, English, Biology, Business Economics, History, Afrikaans)
Other Competency
Driving Licence: B
Career History
JANUARY, 2016 – PRESENT
DEPARTMENT OF Employment and labour (FREE STATE PROVINCIAL OFFICE)
Claims Processor
Duties:
New Claim Registration (Injury on Duty/Occupational Disease/Fatal),
Verification of IOD Claims
Adjudication of IOD Claims
Calculation of Permanent Disablement/Total Temporary Disablement Benefits
Employer and Employee IOD Enquiries
Compensation Fund Advocacy Capturing of Clients Banking Information
Quality assurance for medical accounts and payment
Banking details administration
Bid Evaluation Committee Member (FREE STATE PROVINCIAL OFFICE)
Duties:
Evaluate the responsive bids only according to the pre-approved evaluation criterion and user specification as per bid document.
Investigate and confirm whether the bidding company has the ability and capability to execute the contract.
Implementing the PPFA and BBBEE Act.
Verify whether national industrial Participation programme requirements have been complied with for contracts in access of R10 million.
Verify that contracts of R10 million and above have been sanctioned by national Treasury.
Prepare a recommendation report on each Bidder as part of the Bid Evaluation Committee Recommendation Report.
April 2009-Dec 2015 (Queenstown Labour Centre)
Client Services Officer
Duties:
Monitor and oversee the help desk at the first point of entry
Render employment services to clients
Grievances and dispute resolution
Render advice on Labour Relations
Manage cases of client grievances
Receiving of UIF applications and employer declarations
Receiving of COIDA applications and employer registration forms for COIDA
Render general administrative work and participate in advocacy sessions
Administration & Filling Data Compilation UIF and COIDA claims
Metropolitan life
July 2008 to March 2009
Personal Financial Advisor
Prospecting new clients & expanding the database to include new clients
Responsible for all the servicing and sales aspect of the database
Providing support and assistance to clients and sub agents, on issues such as credit control, conservation and servicing
Liaise closely with team, colleagues & Development Manager to share product enhancement and sales strategies
Coordination with the sub agents in the preparation and execution of the strategic business development / marketing plan
Competencies
Innovative
Leadership
Project management
Compile and Consolidate reports
Self-motivation
Goal oriented
Computer Literate
Customer oriented
Sound written and verbal communication skills
Time Management
Presentation skills
References
Mr Motlhodi Boy
Department of Employment and labour - Supervisor Compensation Fund
Email: adxis8@r.postjobfree.com
Mr Tumelo Sechele
Department of Employment and labour - Supervisor Compensation Fund
Email : adxis8@r.postjobfree.com
Mr Velaphi Helu
Department of Employment and labour Assistant Director : ICT Administration and Office Services
+27-51-505-**** ӏ +27-71-675-****
Email : adxis8@r.postjobfree.com
Mr Lazola Mbobo
Department of Employment and labour - Supervisor Compensation Fund
Email : adxis8@r.postjobfree.com
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