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CV Profile No.84373

Profile

Contact this profile for a recruitment
Last name : *****
First name : ******
Phone : +2**********
Email : ******@******
Date of birth : : ********
Nationality : ***********
Address : *******************************************************************************

Attached CV :

Profile details

Job category searched
» Services
Professional experience
More than 10 years
» Banking, insurance, finance
Professional Experience: 
Since 01.2018
Self Employed
MDneka Productions
Operating in the procurement space, sourcing and supply of products and services.
07.2014 - 08.2017
Forensic Investigator
Discovery Health
I am a Seasoned Insurance professional with vast experience in Long, Short term (Funeral) and Medical Aid. My tenure has always been in the risk area. I am very innovative and good at forging relations with stakeholders. The position required that you find ways to research billing guides and procedures to detect any misdemeanor, positive findings will result in making contact with the Provider in order to negotiate recoveries. Preparation of reports.
01.2008 - 09.2012
Claims Manager
FMI
The company is the leader in Income protection insurance, my role included quality assurance of decisions made, handling of all repudiations and escalations. Tasked with the responsibility of aligning the company philosophy with claims decisions. I was the overseer of fraud detection and management for the company portfolio.
06.2007 - 12.2007
Life Undewriter
Capital Alliance
Medical and Avocational selection of risk.
06.1998 - 10.2006
Health Underwriter and Team Leader(Forensic Investigations)
Discovery Health
Medical and avocational selection of risk pre-1998 Medical Schemes Act amendment. Application of exclusions on pre-existing conditions. Investigation of Non-Disclosures, Identification of collusions between Health Providers and Scheme members.
01.1991 - 05.1998
Trainee Underwriter, Senior Underwriter, Team Leader
Fedlife and Fedsure
Medical and Avocational assessment of risk. Negotiating terms with reinsurance companies Liaising with medical practitioners
Skills
Negotiation" Problem solving"sound investigative"communication"
Education
High school
01.1986 - 11.1990
Matric
Buhlebuzile Secondary School
Languages
afrikaansintermediate
englishfluent
More information
immediately
Gauteng
Place of residence : Johannesburg
Permanent contract
13.01.2021
8

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