Ishmael Seema

Diploma in tourism ,Basic ambulance assistant.Icd10 and CPT Coding basic Coding who is passionate about making a change to society. Dedicated, enthusiastic and loyal. Customer oriented strategic thinker. Proactive with a focus on solutions. I am also community leader, and I am very interested in uplifting my community. mentor.

ADMIN TEAM LEADER - Intercare Sandton Day Hospital - Sandown, South Africa

(2024-03)

• Coordinated, monitored, assigned, and documented patient and clinical care activities.
• Built strong relationships with patients and families for optimized care satisfaction.
• Ensure that frontline personnel deliver a quality customer service.
• Manage the provision of accurate information to customers.
• Develop sound working relationships with internal and external customers.
• All queries to be handled courteously and professionally within 24 hours.
• Oversee duties of housekeeping staff to ensure hospital standard with regards to hygiene, linen, waste management and refreshments are met.
• Ensure sound operational practices aligned with the operating model of the Organization
• Communicate processes and admission / discharge rules to frontline personnel and patients.
• Inform patients of all expected procedures and related protocols with regards to admission processes
• Minimize admission times by promoting and ensuring pre-admission processes
• Ensure all admission information is captured in time and correct.
• Assess billing information and ensure corrections.
• Ordering, receiving and controlling of stationery, consumables and printing stock.
• Supervision of cleaning and booking of learning centre and session rooms.
• Ensure maintenance of office equipment including but not limited to computer hardware copier machines, printers, etc.
• Ensure adherence to operational standards to achieve legislative compliance
• Ensure that all referring and attending doctors are captured on the system in line with the process.
• Regularly maintain and review Trimed and Medikredit set-up.
• Ensure that all patients admitted have the required authorisation and / or made the required payments prior to admission.
• Ensure that all files are audited, finalized and released for payment purposes.
• Achieve financial target that meets the growth agenda
• Ensure compliance with company processes and policies.
• Communicate all payments required to patients prior and during the episode of admission.
• Communicate to medical aids where required with regards to authorisation and payments.
• Oversee the claims management process and ensure that targets per hospital are met on a daily basis by submitting the claims management spreadsheet on a weekly basis.

Clinical coordinator - Mso international

(2020 - 2024)

• Pre authorization for clinical cases. Call center clinical advise.
• Claims inquiry Medical evacuations
• Authorise treatment overseas for travel insurance clients

Confirmation Clerk - Mediclinic Sandton

(2011 - 2017)

• Obtain authorisation and re-authorisation for all identified patients to ensure fully paid claims
• Capture data and communicate to all parties
• Identify and refer risk cases to minimise financial risks
• Adhere to clinical coding standards as per Level 2 coding guideline
• Ensure compliance to the confirmation procedure contracts and legal aspects by utilising available resources and systems

Diploma - Tourism, Basic Ambulance Assistance, icd10 code Basic - Srq school of emergency - Boston city campus

Matriculated - Thuto Lefa high school (2003-01)