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South African National Tuberculosis Settlement
SHADI ADELAIDE SELEPE

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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. 

Experience

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) 
SFE (Workflow) 
PARADIGM 
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.

Education

Institution attended:            Tshwane North College Diploma obtained:             National Diploma in 
Management Assistant 
Duration:              1997-2002 

Name of Institution:            UNISA 
Course:   Programme in Forensic and Investigative Auditing 
Modules Enrolled  Fraud Prevention 
               Fraud Investigation 
Credits:               12 Credits per module 
Standard of the course:           NQF level 6 
Tuition:               Distance Learning 

 

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