Experience

FEM

• South Africa
• Insurance
• 1 - 100 Employee

• Underwriting Consultant

  • Aug 2018 - Present

  Duties: - Signing up of new clients to increase FEM’s policy holder base. Newly registered and state transfers- Dealing with various organization’s affiliated to the construction industry- Providing feedback to various stakeholders with regards to policy and claims queries- Servicing FEM policy holders- Presenting to various stakeholders, industry bodies and potential clients- Training to policy holders on underwriting matters- Facilitating claims training.Extra Duties:- Microfilming- Training of new staff- Change Agent

• Medical Claims Administrator

  • Mar 2017 - Jul 2018

  Duties: - Accurately assess accounts and administer claims in line with the Government Gazettes.- Processing of Temporary Total Disablement (TTD) payments in line with the Compensation for Occupational Injuries and Diseases Act, 1993 (COID).- Processing of Permanent Disability (PD) payments in line with the Compensation for Occupational Injuries and Diseases Act, 1993 (COID). - Capturing of injured employee wages.- Capturing of injured employee bank details.- Liaising with all relevant stakeholders.- General administration of claims.

• Accounts Authorisor

  • Dec 2016 - Feb 2017

  Duties: - Accurately authorising claim payments sent through by claims assessors and ensuring information captured is in line with Government Gazettes and internal instructions.- Handling queries related to claims from the relevant stake holders.- Processing of accounts, using Spesnet online system. - Authorising TTD and PD payments.- Authorising injured employee and service provider bank details.- Authorising wage change requests.- Authorising name change requests.



FEM

• South Africa
• Insurance
• 1 - 100 Employee

• Training Consultant - Contract Work

  • Jul 2016 - Jul 2016

  Duties: - Assisted with the information for the internal E-Learning system - Checked the information that was already gathered and rectified where required - Assisted with the audio and visual recording for the different sections within the claims, pensions and underwriting department - Completed the “formative” test questions for the claims section for the internal E-Learning system Duties: - Assisted with the information for the internal E-Learning system - Checked the information that was already gathered and rectified where required - Assisted with the audio and visual recording for the different sections within the claims, pensions and underwriting department - Completed the “formative” test questions for the claims section for the internal E-Learning system



FEM

• South Africa
• Insurance
• 1 - 100 Employee

• Claims Manager

  • Mar 2015 - Oct 2015

  Duties: - Training new staff on COIDA and Government Gazettes.- Weekly refresher training for staff.- Internal Audits.- Answering queries from internal and external stakeholders.- Policy holder and Service Provider visits to provide training and handle any queries and concerns.- Staff Management for 2 supervisors, 8 claims assessors and 4 registry clerks.- Monthly reporting on branch performance (new registrations, fatal claims, payments made, staff performance, stats, new and existing projects).- Checking the monthly re-insurance schedule. - Approving treatment and payments in line with FEM Internal instructions.- Referring claims onto the National Claims Manager for further approval above my limits.- Conducting performance appraisals for staff members.

• Claims Supervisor

  • Jul 2014 - Feb 2015

  Duties: - Allocation of new claims to the assessors.- Weekly follow ups on existing claims.- Internal Audits.- Reversing and re-issuing of incorrect payments.- Answering queries from internal and external stakeholders.- Staff Management for 7 claims assessors.- Accurately assess accounts and administer claims in line with the Government Gazettes.- Monthly reporting on branch performance (Claims processed, claims finalized, claims registered, documents scanned and indexed……).- Complete the monthly re-insurance schedule.- Provide training.

• Acting Claims Manager

  • Feb 2014 - Jun 2014

  Duties: - Training new staff on COIDA and Government Gazettes.- Weekly staff refresher training.- Internal Audits on claims.- Answering queries from internal and external stakeholders.- Policy holder visits to provide training and handle any queries and concerns.- Staff Management for 1 supervisor, 5 claims assessors and 1 registry clerk- Monthly reporting on branch performance (new registrations, fatal claims, payments made, staff performance, stats, new and existing projects).- Complete the monthly re-insurance schedule. - Approving payment of permanent impairments up to 5%- Referring claims onto the National Claims Manager which were above my limits.- Conducting performance appraisals for staff members.

• Accounts Authorisor

  • Jul 2004 - Jan 2014

  Duties: - Accurately authorising claim payments sent through from approximately 20 assessors and ensuring information captured is in line with Government Gazettes . - Calculating & Authorising TTD and PD payments.- Confirming & Authorising injured employee and service provider bank details.- Calculating & Authorising wage change requests.- Confirming & Authorising name change requests.Extra Duties: - Training of new staff - Auditing claims to ensure that the acceptance of liability and finalisation of these claims has been done correctly.- Assisting external auditors.- Retrieving information from microfilming as and when required.- Health and Safety Representative. - Fire Marshall.- Facilities Maintenance.Achievements: - Received the Executives Award for Excellence in 2010 and 2011.

• Medical Claims Administrator

  • Oct 1999 - Jun 2004

  Duties: - Accurately assess accounts and administer claims in line with the Government Gazettes- Processing of Temporary Total Disablement (TTD) payments in line with the Compensation for Occupational Injuries and Diseases Act, 1993 (COID)- Processing of Permanent Disability (PD) payments in line with the Compensation for Occupational Injuries and Diseases Act, 1993 (COID) - Capturing of injured employee wages- Capturing of injured employee bank details- Liaising with all relevant stakeholders- Assisting with training of new claims assessors



Chamber of Mines

• City of Johannesburg, Gauteng, South Africa

• Medical Aid Assessor

  • Jan 1995 - Mar 1999

  Duties: - Arranged and made payments of medical accounts in line with tariffs and according to the availability of funds in the members Medical Savings Account (MSA) - Processed cheque runs monthly - Sending out monthly remittance advises to all stakeholders - Office admin (filing of documents) - Managing ± 8 temporary staff members  Training and development  Issuing and checking of work  Resolving issues Duties: - Arranged and made payments of medical accounts in line with tariffs and according to the availability of funds in the members Medical Savings Account (MSA) - Processed cheque runs monthly - Sending out monthly remittance advises to all stakeholders - Office admin (filing of documents) - Managing ± 8 temporary staff members  Training and development  Issuing and checking of work  Resolving issues