The applicant is applying for the Pension Medical Case Auditor Team Leader position and believes they have the necessary qualifications based on their extensive experience managing customer service teams and reviewing medical cases in the healthcare industry. They currently oversee a team that prepares special cases for members needing excluded benefits or clinical appliances over R50,000 and have a comprehensive knowledge of healthcare procedures. The applicant is confident they can make a positive contribution and welcomes an interview.

1. 16 November 2016
The Recruiting Manager / Human Resource Manager
Rand Mutual Assurance
I am very interested in the Pension Medical Case Auditor Team Leader position as advertised on LinkedIn
(16 November 2016). I believe I have the necessary qualifications and skills to successfully fulfil your
requirements.
As you review my enclosed curriculum vitae you will see that I have extensive experience as a Customer
Service Manager in the Healthcare services industry, I have proven myself to be a competent team player
with the capacity to manage a number of diverse Customer support functions (Call centre Operations,
Special Clinical Cases Review, Council of Medical Schemes queries administration, Social Media queries,
Finance queries, Membership queries, Emails queries, Escalations, Claims query assessing)
My job has required strong planning and organizational skills coupled with an in-depth analytical approach
to problem management. I have also had the opportunity to develop strong interpersonal communication
and customer assessment skills.
My current job entails overseeing the Clinical Cases Reviewers; this team prepares and present Special
Cases:
 Members in need of excluded benefits,
 Members in need of Clinical Appliances and Prosthesis
 Members who need Ex-gratia funding >R50 000 – I have the Mandate to approve Ex-gratia requests
up to R50 000)
Their preparations includes engagement of service providers with regards to quotes for Appliances &
Prosthesis; engagement of Case Managers with regards to updates on LOS ( Length of Stay) and LOM’s
(Letters of Motivation) in case of excluded benefit e.g. Biological Drugs on certain options.
My comprehensive knowledge of the Healthcare industry, procedures and resources necessary for
successful management of a large and diverse customer base has enabled me to efficiently implement
strategies for large scale client support and service. I am a highly motivated employee who is passionate
about providing exceptional client service and satisfaction.
I am confident that I can make a positive contribution to Rand Mutual Assurance. I would welcome the
opportunity to meet with you for an in-depth discussion and am available for an interview at your earliest
convenience.
Thank you for your time and consideration and I look forward to speaking with you soon.
Yours Sincerely,
Mrs Strelitzia Monde More
312 Hampoen Street
Ormonde View
072 123 3558 / 011 758 8538

2. 312 Hampoen Street
Ormonde View
JHB South
2091
Work 011 758 8538
Cell: 072 123 3558
E-mail mondemr76@gmail.com
Monde Strelitzia More
Objective  To implement the knowledge I have gathered during my work experience.
 To contribute in improving service in the service Industry of South Africa
 For career advancement
Professional
experience
23/07/2012 to date Medscheme Holdings Ltd (PTY)
Bonitas Call Centre Back Office Manager
 Ensure that the company Balance Score Card is achieved
 Ensure that Service Level Agreement is achieved and maintained to ensure
that no penalties are paid ( 90 % of queries received to be resolved within 1
business day; Claims queries to be actioned within 5 days, maintain the VOC
(Voice of the customer) score of 85% satisfaction, 95% Escalation queries to
be resolved within 1 business day)
 Ensure that the ISO processes and standards are adhered to.
 Manage 62 Staff including 4 Team Leaders
 Development of the Team leaders
 Performance management of staff, to ensure that the KPI’s are achieved.
 Ensure that the department is operating within set Budget
 Ensure staff development by Multitasking & organization of training
 Recruitment & Induction of new staff.
 Ensure that Good Client relationship is maintained.
 Attend to escalated queries and complaints (telephone /correspondence)
 Formulation & analysis of reports to be presented to the Senior Manager,
General Manager, CEO & BOT.(Chief Operations Officer, Chief Executive
officer & Board of Trustees)
 Authorisation of Ex-gratia payments and Exclusion s overrides ( evaluate and
approve as per clinical indication)
 Maintaining good relationship with the CMS( Council of Medical Schemes)
*Signing off communication to the CMS
*Overseeing the Special Committee Meetings and Appels from CMS
 Maintaining good relationship with Bonitas Medical Fund
*Overseeing all escalations and complaints raised with the Principal Officer
ACHIEVEMENTS:
 Achieved and Maintained the SLA monthly
 No Penalties paid due to service failure not missing the SLA’s
 2 Of my Team Leaders promoted to Management positions
 Two of my staff were winners on the staff Awards in 2012- 2013, One got the
Platinum prize. In 2013 -2014 had 2 Team Leaders nominated as Finalists in
staff Awards.
01/02/2011 to 20/ 07 /2012 Doves Financial Services (Subsidiary of Numsa
Investment Companies)

3. Contact Centre Manger
 Managing Sales force, selling Funeral Insurance, Health Insurance.
 On the job coaching and training of subordinates
 Data Analysis (Stats and formulating reports)
 Assisting with complex queries
 Managing complaints process for Doves Group.
 Managing Performance and development of agents
 Ensured that ABSA /Numsa Strategic Alliance is effected efficiently
 Ensured that sales agents are FAIS accredited
01/06/2008 to 31/01/2011 Thebe ya Bophelo Healthcare Administrators (TYB
health )
Call Centre Manager
 Ensure that the company Balance Score Card is achieved
 Ensure that the ISO processes are adhered to.
 Manage call center agents + a Receptionist
 Performance management of staff, to ensure that the KPI’s are achieved.
 Ensure that the department is operating within set Budget
 Ensure staff development by Multitasking & organization of training
 Recruitment & Induction of new staff.
 Ensure that Good Client relationship is maintained.
*Attend to escalated queries and complaints (telephone/correspondence)
 Formulation & analysis of reports to be presented to the COO, CEO &
BOT.(Chief Operations Officer, Chief Executive officer & Board of Trustees)
 Assisting Disease Manager with processes within the department.
ACHIEVEMENTS:
 Managed to train two interns now permanently employed
 Groomed an agent to a team leader in the department
 One of my agents was the recipient of the best employee in Thebe Investment
Company(TIC)
01-07-2006 to 31/05/2008 - Digital Healthcare Solutions
General Support Supervisor
 Maintain good client relationship
 Monitor and manage staff performance
 Formulating and analyzing reports
 Handling management calls and escalated queries
 Ensuring excellent customer service is rendered at all times
 Training new recruits and On the Job training of agents
 Monitoring and ensure that service level agreement is adhered to
 Conducting Interviews for new staff
 Counselling and Disciplining staff
 Grooming of agents
ACHIEVEMENTS:
 Managed to improve service level from 47% to 85% and abandoned rate from
27% to 2%.
 My team has an area of growth by introducing levels of seniority in the call centre.

4. 01-10-2004 to 30-06-2006 African Life Health
Customer Service Supervisor (2 IC)
 Supervision of staff
 Maintaining client relationship
 Ensuring member retention
 Supervision of Receptionist & switchboard
 Standing in for Customer Service Manager
 Assisting in doing Budgets for the department
Reason to leave
Company was relocating to Centurion.
Wanted to broaden my Horizon in healthcare.
ACHIEVEMENTS
 Managed to build a fully fleshed customer call center department.
 Managed to maintain service level of >85%
 Had an input in the new CRM system and was introduced.
01-07-1996 to 30-09-2006 Medscheme
Call center Supervisor (from 01-04-2000)
Supervision of staff as above
 Responsible for recruiting and training new agents
 Team coach (February 1999- to March 2000)
 Mainly on the job training
 Coaching of other agents
 Handling of difficult clients
 Assessing of complicated claims
 Handling priority queries
REASON TO LEAVE
Left for career advancement
ACHIEVEMENTS :
 Was nominated Employee of the year for two consecutive years (1998-1999)
 Was promoted to Team Coach (1999- 2000)
 Further promoted to Call center Supervisor Position (2000)
 Selected to do recruitment & training of new staff (from 7 Supervisors)
02-02-1987 – 30-06-1996 Baragwanath Hospital
Professional Nurse from 01-02-1991 – 30-06-1996.
Student Nurse from 02/02/1987 to 01-02-1991

5. REASON TO LEAVE
Needed further professional growth and to broaden my healthcare Horizon.
01-03-1986 – 30-11-1986 Shongwe High School
Private teaching whilst on waiting list to go to Baragwanath (6 months)
Summary of
qualifications
In Progress 3
rd
Stage - Master in Business Administration (MBA)
Mancosa (Management College of South Africa)
Modules passed (NQF level 8 ( BBA equiv))
Human Resource Management, Marketing Management, Management of
Information Systems , Operations Management, Economics, Corporate Strategy,
Managing Strategic Change, International Business, Healthcare Management,
Quantitative Measurements (Stats), Accounting for Decision Making, Managerial
Finance.
1999 Programmed in Business management UNISA
Major Subjects
Management Principles, Marketing Principles, Business Communication, Self-
management. Business finance and Accounting (outstanding)
02-02-1987 – 01-02-1991 Baragwanath Nursing College
Diploma in Nursing
General nursing, community nursing; pshychiatric nursing, Midwifery.
Other courses:
2007-Electronic Data Interchange
ICD 10 Training
Microsoft Excel 2003
2001 NICE UNIVERSE TRAINING (Neptune intelligence computer engineering)
-Call monitoring; call evaluation; call recording.
1999 - On the Job Coaching
1998 Conflict management
CPT & ICD 10 codes
1997 – Customer service Support
Telephone Skills
Business Communication
1994 - 1995 – Home study college (Certificate in Industrial psychology)
1991 - HIV Counselling course Baragwanath Hospital
Education 1985 – Shongwe High School Mpumalanga (previously Eastern Transvaal)
Matric.
Leadership
Abilities
 Acting Chief Local Officer (Church Elders)
 Church Secretary

6.  Contact Centre Back Office Manager (July 2012 to date)
 Call Centre Manager ( June 2008 to 2012 )
 Supervisor (April 2000 to May 2008)
 Team coach (1999 to 2000)
 Class rep for three consecutive years during my Nursing training (1989 to1991)
 Deputy Head prefect in 1985
 Drum Majorettes leader at High School
References 1.Louisa Sandows
Customer service Manager (ex-African Life health)
0828286693
2. Penny Moiloa
Executive Manager - Health Administration ( Medscheme)
08245462184
3. Raphael Mnisi
Senior Manager – Bonitas Business Unit (Medscheme)
011 671 4485 / 082 928 2186