About SHADI ADELAIDE SELEPE:
I have extensive experience in administrative and clerical functions in various fields, as well as data capturing. I have strong inclination for administration and handling confidential records. I have strong negotiations skills, planning, organization and time management skills, excellent strategic capabilities and leadership and skills. I am capable of interpersonal interaction combined with sound problem-solving capacity.
I have well developed communication skills, telephone, e-mail etiquette and self-driven. I possess high levels of cognitive and emotional capacity, and I am very versatile, adaptable and energetic. I have the ability to communicate well with people at different levels and from different backgrounds, ability to act with tact and discretion, ability to research and analyze documents and situations. I contribute towards achieving the vision of the company and making our clients feel very important and accepted. I have a good organizing skills and I’m analytical to tasks that I’m given by my seniors.
I’m working as a Senior Lumpsum Claims Assessor Discovery Employee Benefits Group Risk and deal with clients on daily basis. Because of my experience I am confident that I will be an asset to the company. The education I’ve got was by learning and practicing. (Meaning the work I have educated for was done daily). I’m able to apply all my previously acquired skills and develop the best of my abilities. I have vision and goal orientated. I respect different cultures and communicate very well. I have abilities to meet set deadlines, analyze challenges and to make positive judgement.
Assessing and authorising the below Benefits through SOPS:
Assessing Funeral Benefit
Assessing Approved and Unapproved Group Life Benefit
Assessing FLEX Unapproved Benefit
Assessing Approved and Unapproved Disability Benefit
Assessing Severe Illness Benefit Claims
Assessing FLEX SIB Benefit
Assessing Mortgage Protector Benefit
Assessing Family Protector Benefit Systems Used:
COMPASS (Processing manual claims)
Assessing each claim on the claim administration system and identify the type of claim
Assessing the validity of the identified claim by assuring all the supporting documentation has been submitted. (assess the documentation in terms of signed claim form, ID of deceased, Proof of bank details, Death certificate, BI-1663 / DHA-1663)
Valid claims are processes on the administration system and send for payment
Claims that have outstanding documentation: Client will be notified of outstanding requirements
Invalid claims will be Declined/ Repudiated
All claims processes must align to SLA and SOPS
To maintain and error rating of less than 0.5 %
Assuring capturing of claims are done accurately
Assuring all criteria is met to pay claim
Assuring the quality of feedback (written and verbal) to clients
To ensure that clients are provided with real time information on the status of the claim (feedback on the claim processing)
Assuring feedback on requirements for successful claims payment is done timeously
Attending Telephone queries
Checking if the scheme is in credit control & confirming member’s annual salary
Updating and checking ASISA
Updating and checking deceased’s TransUnion
Verifying deceased’s records on ASTUTE (Death, Birth, Lineage and Marriage)
Loading and capturing members on system
Managing own turnaround times (SLA) and attending all general queries
Extracting Claims Reports (Paid and Pending claims)
TSC - Logging calls and capturing of critical information on system.
Institution attended: Tshwane North College Diploma obtained: National Diploma in
Name of Institution: UNISA
Course: Programme in Forensic and Investigative Auditing
Modules Enrolled Fraud Prevention
Credits: 12 Credits per module
Standard of the course: NQF level 6
Tuition: Distance Learning
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