Asa Len

I am an enthusiastic, self-motivated, reliable, responsible and hard working person who is able to work without being monitored and deliver high quality support and results to both internal and external partners, treating all request with sense of urgency, knowing that all queries and request need urgent resolution, I am excellent team worker and am able to take instructions from all levels and build up good working relationships with all colleagues. I pride myself at being reliable and trustworthy while working remotely 80% most of my time.

Dispensing Optician Inservice Training - Torga Optical:Kenilworth Center

(2006-02 - 2007-02)

• Optical benefits confirmation (with all medical aids)
• Refraction testing(screen testing)
• Laboratory lens ordering and checking of prescription.

Dispensing Optician - Execuspecs; Old Mutual (Pinelands

(2007-03 - 2010-10)

• Optical benefits confirmation(with all medical aids)
• Laboratory lens ordering and checking of prescription
• Invoicing the jobs using correct SAOA and PPN tarrif Codes
• Ensure the quality of the lenses the laboratory provides is sound and checking the prescription whether is correct
• Claim submission

Claims specialist - Metropolitan Heath Group(GEMS Business unit)

(2010-11 - 2013-02)

• Review any system warnings and make decision whether the claim should be forced through.
• Interact with team leader and colleagues when required order to Manage work load.
• Assist with claim investigation and queries.
• To e-mail investigations, escalated complaints and client service queries .
• Provide quality written feedback to claims queries
• Liaise with external business partners.
• Create and update manuals and process flows.
• Create special batches ,ensures all correspondence is archived and deal with maintain a 24 hour turnaround time.
• Provide feedback on reports and to external partners.
• Assessing both Edi and paper claims.
• Foreign claims conversions and processing.
• Assisting with the ex-gratia process.
• Facilitate resolution to Gems dental queries.
• Facilitate amendments to repricing of MHRS hospital claims.
• Assist with daily and monthly QA claims reports (web reports).
• Assist with claims flows between MHG Gems and its Business Partners.
• Orthodontics case management.
• To ensure scheme exclusions are applied.
• Ensure account is paid from correct benefit.

Claims Technical Specialist - Metropolitan Heath Group

(2013-02 - 2023-12)

• Second level support
• Provide support to Claims Ops,PLOs and CLO queries
• Project support.
• Tax project(Annual and Bi-annual)testing
• Performing user acceptance testing
• Performing benefit testing for GEMS ATS team
• Performing benefit testing for GEMS GIA team
• Performing benefit testing for HM team
• Performing benefit testing and scheme rule changes
• Production testing after go-live.
• Assisting with training briefing for work delivered by projects.
• Assisting with the creation and maintenance of training materials
• Assisting with drafting of specification document and enhancements.
• Receiving SPN queries and operational problems, providing solutions and feedback to end user and the business.
• Liaise with Ambulance,Dental ,Maternity and Optical SPNs during testing of benefits changes and enhancements as well post live
• Liaise with external business partners.
• Ad hoc queries.
• Logging SDs/Incidents and following up
• Liaison with IT.
• Interface monitoring with SPNs.
• Monitoring workflow and operational processed and reports.
• Reporting on team performance
• Contributing to regular BU and scheme reports
• Improving and automating reporting functionality to limit the need For manual intervention.

Business systems Administrator - Metropolitan Momentum Holdings

(2024-03)

• Second level support,pulling data of data according to specification
• Troubles shoot disruptions of input and output files
• Project support.
• Resolve escalated user queries on JIRA
• JI JIRA allocation to designated areas
• Investigate system errors and monitoring aster resolution
• Performing user acceptance testing
• Performing UAT for processes for BU and GEMS scheme
• Production testing after go-live.
• Training BU on changes from changes and enhacements
• Assisting with the creation and maintenance of training materials
• Assisting with drafting of specification documents and BLD(business logic documents).
• First contact on SPN queries, problem resolution contact
• Solutions and feedback to end user and the business via JIRA.
• Testing of benefits changes and enhancements as well post live
• Liaise with external business partners.
• Ad hoc data request.
• Logging SDs/Incidents/error logs and following up
• Liaison with IT.
• Interface monitoring with SPNs input and output.
• Improving and automating reporting functionality to limit the need For manual intervention.

Senior Certificate - Uxolo High School (2003)

ND Dispensing Opticain - Health and Wellness Science - Cape Peninsula University of Technology (2007)

ND:Management-In-complete - Business Faculty - Cape Peninsula University of Technology (FDP) (2010)

Public Administration, Local Government, Micro economics, Public sector, Information and communication Technology, Public Law - REGENT BUSINESS SCHOOL