Overall
Promotion
Salary
Work/life balance
Culture
Leadership
Excellent processing skill
TYPICAL WORK DAY Capturing and processing of all incoming paper claims within Service Level Agreement(SLA) -Processing of claims according to predetermined standards and rules -Ensuring that duplicate claims are rejected in accordance with the correct rejection code -Assisting other departments with claim related queries - Quality control to ensure error rate is minimized -Escalating of queries where necessary for further investigations Interpersonal skills -Being able to get along well with co-workers and accept supervision Flexibility and Adaptability -Being willing to try new things and am interested in improving efficiency on assigned tasks, able to work independently Attention to detail -Concerned with quality. Produce work that is orderly and attractive. Ensure that tasks are completed thoroughly and precisely The challenge is meeting the target everyday, but I work over and above what is expected of me by going extra mine
Pros: Good processing skill
Cons: Long working hours
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Excellent Teamwork, Great learning experience and Target motivated
Before i came to Metropolitan I was from a very small NGO and was so used working by myself. Metropolitan had somehow taught me to be part of a bigger scale of people and be part of a team. I can easily say that by now I excel in team work and being part of a bigger group is way better. The most challenging part was mainly trying to come out from my shell and be part of something bigger. I was so used and comfortable working by myself which became quite challenging when I was put into a team.
Pros: Learning curve, revenue driven
Cons: Company moving from Pretoria to Johannesburg without any salary adjustment
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It is a great company to work for, it has taught me a lot about customer service
Metropolitan gave me an opportunity to learn the medical health industry, call centre enviroment as well as re-procesing & capruring of medical claims
Pros: great company to work for
Cons: I haven't came across any
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Quick to learn, excellent telephone and email etiquette, punctual, able to work independently
The work gives me the opportunity to build good healthy relationships with fellow co worker as for me to be more effective in what I do I need to be part of a team. Communication is key and has proved to be the single most important thing that helps me make informed decisions in my line of work, e.g if there is a challenge in any of the department I liaise with on a daily basis I expect to be notified. The most fulfilling part as a claims assessor is that every claim is viewed as a new case that requires my expertise in solving and each case is always difderemt from the other. I have learned to be more reliable, efficient and more accurate in my work as a lot of stake holders are affected by the out come of my decision
Pros: Great opportunity to learn
Cons: Short stuff
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Profission learning
am working at a busy company dealing with different members and service providers. I came here with any knowledge related to medical aid but now I am proud to explain to other people how it works. I enjoy assisting difficult members because they end up enjoying your service.
Pros: great opportunity to learn mor abot the medical aid
Cons: the working hours are normal
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Excellent learning curve
Ensuring the resolution of client queries and aim to achieve first call resolution Maintain goodwill of the company by upholding the SLA standards Investigate queries where necessary and provide timeous feedback to the member accurate logging of information for statistical reporting purposes Escalate queries were necessary to ensure members satisfaction Interpret the query and determine appropriate path of resolution
Pros: Great opportunity for growth
Cons: Flexible hours
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Excellent learning curve
I work from 8 to 5, but my department is flexible and i mostly like starting my day early so i can get a head start. I love talking and working together and laughing and reasoning with my co workers. I do Disease risk management (Oncology, Psychiatry and Renal Failure - 4 months rotation on each), Respond to email requests and queries, , meeting turnaround times and deadlines with reports. Claims process, Review request for exceptions. Recommendation to hospital case management, pre authorization and chronic team about clinical appropriateness of treatment and medication. I have learnt a lot and i didn't know much about disease management The most challenging aspects of the job is oncology but also very interesting, the volatility of the company - encourages me to work harder , also my job challenges me personally.
Pros: Great opportunities to study
Cons: confined to chair
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My great experience in my working life
I believe that my skills, experience, and reputation for excellence can greatly enhance your company performance. I have an ability to grow with a job, handle responsibility and build positive relationships with work colleagues at all levels. I am someone who knows how to set goals and achieve them, and have a proven track record of being able to conceive, develop & execute strategies. My long term career goal is to continue to learn and grow my specialist skills and abilities, whilst utilising my experience, knowledge and skills to benefit any employer I am working for. I am available for an interview at any time, and should you require any further information then please do not hesitate to contact me. In the meantime I thank you sincerely for taking the time to read my application, and I very much look forward to an opportunity to speak to you in more detail regarding this position
Pros: Communication skills
Cons: 10 hours
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Attention to detail
would like part of your winning team About me, I am currently a Regional co-ordinator for Metropolitan Health under the GEMS business unit, been in this role since June 2015 and been with the Metropolitan Health business since June 2009. Before that I was a Team Leader in the billing and recons department in the corporate schemes BU with the same company for 5 years. Expected of me in this role is to manage staff in the branch and ensure that we provide clients with excellent service at all times. A client centric space where I deal with escalated enquiries from GEMS clients and from scheme officials who visits the walk in centre. I have explored my skills and capabilities in several different departments within the company and have a good understanding of this organization, its values and mission; I have done my utmost best to live within them. I have found the company to be a very well-run organization and supportive of its employees. Kindly receive my resume attached Sabelo Ntshanga
Pros: Management development
Cons: Long working hours
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Excellent learning opportunities
my typical day at work is to capture and process claims send by service providers and members to do the job i am currenty doing you need to be focus / dedicated/ and most of have client intrest at heart / good working relationship with co-workers as we also deal with other SPN
Pros: opportunity for promotions
Cons: long working hours
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