HOD Claims and Remittance, BSc Hons Health Information Management

SAMANTHA KEFILWE DE BRUIN

Postal Address: P O Box 47619 Gaborone, Botswana

Email: ******.*******@*****.***

Cell: +267-********

Nationality: Motswana Gender: Female

PERSONAL SUMMARY

A highly competent and experienced health Information management and billing professional with proficiencies cutting across designing and tailoring research data collection and monitoring & evaluation tools, analyzing data, optimizing data management systems and providing comprehensive billing service. Having proven to be a reliable self-directed professional with a strong work ethic and readiness to become a valued team member in the public health and research field, I aspire to fill a position where I can apply my skills, knowledge and experience in a competitive environment. WORK EXPERIENCE

January 2019 to date- Claims and Remittance Officer Optimum Health Medical Laboratories

Confirmation of funders status through medical aids portals

Ensure correct capture of patient demographics, medical aid numbers, doctors practice codes, lab tests and ICD 10 Codes into the system

Ensuring payments are done for the resigned, suspended, terminated, non-active clients

Audit and submit claims to funders.

Reconciling and analyzing medical aid remittances

Calling clients for funders unpaid bills settlement

Balancing and depositing sales money on a daily basis

Reconciliation of sales and issuing petty cash for company expenses as per need. April 2019 to September 2019- Billing Clerk (part time) Gaborone Cancer Clinic

Administered and registered all patients on the management system

Balanced daily advances and submissions to cash office for reimbursement

Handled all patient queries and enquiries regarding the health services

Ensured completeness of patient demographics upon registration

Made appointments for patients to meet the oncologist or be administered chemo.

Liaised with funders on pre authorization of patient’s procedures

Captured stock using nappi codes from Medikredit July 2017 to December 2017- Billing Clerk

Lenmed Health Bokamoso Private Hospital

Collected billing information by analyzing clinical services rendered to patients and insured that its accurately charged.

Collected and captured patient details into the R Care Magnum system

Checked patients records for completeness and accurate coding before claims submission

Counter checked requisition forms for validity any non-conformances

Admitted patients and processed appointments for major medical surgeries that worked with the case management department

Cross checked medical aid pre authorization of patient’s procedures EDUCATION

2014-2018- BSc (Hons) Health Information Management, Botho University Obtained GPA: 3.42/4.00

2012-2013- BGCSE, St Joseph’s College

SKILLS AND COMPETENCIES

Proficient in data capture software systems (SPSS, STATA Open MRS, Redcap, DHIS2, EPI Info, SLIMS & R Care Magnum.

Technical report writing skills

Critical thinking and analytic skills

Proficient in Microsoft tools and management systems

Strong organizational and decision making skills

Strong written and verbal communications skills

Statistics and research analysis

Well versed knowledge on public health and epidemiology

Flexibility to support a variety of Division projects

Flexibility with changing priorities, take on unfamiliar tasks ACHIEVEMENTS

Health Informatics Africa 2019 Conference local organizer.

Deans award: academic excellence certificate, Botho University

Cancer awareness community service outreach with Cancer Association Botswana.

Diacore Marathon volunteering certificate.

OTHER ACTIVE ROLES

January 2018 to date- Marketing Lead (Part time)

Botswana Health Information Management Association PROFESSIONAL MEMBERSHIP

Botswana Health Information Management Association (BoHIMA)

International Federation of Health Information Management (IFHIMA)

Health Informatics of Africa (HELINA)

REFERENCES

Dr. Anthony A Masaka. MD. DLSTHM. MSc.

Lecture & Head of Department

Department of Public Health Management

Botho University

*******.******@***************.**.**

Tell: +267-*******/ 74101642/ 7595658

Fax: +267*******

Desire Mhlabi MBA, MPH, BMLS (Hons)

Laboratory Director

Optimum Health Medical Laboratories

******@****************.**.**

Tell: +267-*******/ 77063333/ 76767644

Andrew Sekobileng Mafate

Lenmed Health Bokamoso Private Hospital

Billing Manager

******.******@****************.***

Tell: +267-*******/ 71382688/ 758000

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