Marcel N. Email & Phone Number

Christchurch, Nz

Christchurch, Canterbury, New Zealand

As the Territory Manager for First Aid Solutions in the Canterbury and Southland regions, I lead the charge in delivering exceptional first aid products and training services to a diverse client base. My role encompasses strategic sales, customer relationship management, and operational oversight to ensure the highest standards of safety and compliance are met across all client interactions.

New Zealand

Dedicated and certified First Aid Instructor with extensive experience in delivering comprehensive first aid training programs across various settings in New Zealand. Passionate about equipping individuals and organizations with the knowledge and skills necessary to respond effectively to emergencies.

Auckland, New Zealand

City Of Johannesburg, Gauteng, South Africa

Managed Care Quality of coding:● Work with billing departments to achieve clinical coding excellence on all patient files● Application of clinical and coding knowledge to effectively assign and sequence all ICD 10 and CPT codes for services rendered for each patient event● Read and analyze records from all available digital and other resources for accurate and appropriate coding that reflects the relevant medical history and care the patient received as well as the response to treatment● Engage with all allied service providers to clarify information to ensure complete ICD 10 and CPT coding on each case is achieved● Allocate clinical codes to patients’ current period of care using knowledge of the information contained within the International Classification of Diseases, revision 10, and CPT coding books● Demonstrate expertise in clinical coding and the DRG model and an understanding of the complex cause and effect factors within the broader managed care industry

Corporate Office, Cape Town - Remote Site Working

● Analyzed medical records and determined accurate diagnostic and procedural codes based on ICD-10 coding standards and conventions.● Reviewed physician documentation to ensure complete and precise coding of diagnoses and procedures.● Maintained extensive knowledge of medical terminology, anatomy and physiology, and pharmacology to ensure coding accuracy and compliance with coding guidelines.● Worked collaboratively with healthcare providers and coding department staff to ensure accurate coding and compliance with regulations.● Conducted regular quality checks on coded data to ensure its completeness and accuracy.● Kept up-to-date with coding guidelines and regulations to ensure compliance with current standards.● Participated in coding education and training programs to stay informed of industry advancements and changes.

Johannesburg Metropolitan Area

● Analyzed medical records and assigned accurate diagnostic and procedural codes according to ICD-10 coding conventions and standards.● Reviewed and interpreted physician documentation to ensure complete and accurate coding of diagnoses and procedures.● Maintained knowledge of medical terminology, anatomy and physiology, and pharmacology to accurately assign codes and ensure compliance with coding guidelines.● Worked closely with healthcare providers and coding department staff to ensure coding accuracy and compliance with regulations.● Performed regular quality checks on coded data to ensure accuracy and completeness.● Continuously updated knowledge of coding guidelines and regulations to ensure compliance with current standards.● Participated in coding education and training programs to stay up-to-date on industry advancements and changes.

City Of Johannesburg, Gauteng, South Africa

● Conducted clinical assessments and audits of private and medical aid funded accounts to ensure compliance with medical council laws and regulations.● Managed multiple specialized units as well as general wards to ensure optimal patient care.● Collaborated with healthcare providers to identify and escalate cases that required additional intervention or rectification.● Utilized ICD-10 coding to capture accurate data and ensure compliance management.● Liaised with medical aid providers to ensure payment of all accounts and resolved any payment issues.● Provided training to staff members on relevant policies and procedures.● Monitored and tracked patient outcomes to identify areas for improvement.● Collaborated with interdisciplinary teams to develop and implement care plans for patients.

Cape Town Area, South Africa

● Conducted clinical assessments and audits of private and medical aid-funded accounts.● Ensured compliance with medical council laws and rules to facilitate payment of all accounts.● Escalated and rectified all externally funded patient accounts.● Assessed and monitored state-funded accounts such as COID, RAF, and defense forces.● Applied ICD-10 coding to relevant fields for data capturing and compliance management.● Managed all Level 5 staff placed under my administration for project completion.● Liaised with stakeholders to implement relevant medical policies and guidelines.● Maintained accurate records and reports of all activities and outcomes.● Coordinated with other departments to optimize case management and service delivery.

Johannesburg Area, South Africa

● Assessed and evaluated medical claims to ensure compliance with policy guidelines and medical necessity requirements.● Conducted fraud and clinical forensic analysis of claims to identify and prevent fraudulent activities and inappropriate billing practices.● Managed high-cost and long-distance medical transfers, including clinical and financial management to ensure efficient and cost-effective care.● Processed and batched payments to healthcare providers on a daily basis, ensuring accurate and timely payment.● Provided guidance and training to providers on claims submission, guidelines, and processes to improve efficiency and accuracy.● Maintained up-to-date knowledge of industry regulations and guidelines to ensure compliance with legal requirements and policies.● Communicated effectively with internal and external stakeholders, including providers, policyholders, and colleagues, to resolve issues and improve the claims process.

Johannesburg Area, South Africa

● Assessed and reviewed Clientele Hospital Cashback claims, as well as international insurance claims for medical insurances such as Bupa International, Cigna, and Aetna, to ensure compliance with CPT coding and ICD10 coding for billing purposes.● Case managed international cases, including coordinating flights, and provided constant clinical management of cases to ensure the highest level of patient care.● Communicated effectively with patients, families, and medical personnel to facilitate the most efficient and effective care possible.● Provided expert clinical guidance and support to medical staff and management, ensuring adherence to established protocols and procedures.● Collaborated with insurance companies and healthcare providers to streamline the claims process and improve the patient experience.

Johannesburg Area, South Africa

● Responded promptly to emergency calls, providing advanced life support to critically ill or injured patients before transporting them to a medical facility.● Collaborated with paramedics and other medical staff in delivering advanced emergency medical care in accordance with established protocols and procedures.● Managed patient airways, administered medications, and performed advanced medical procedures as necessary.● Provided comprehensive pre-hospital care to patients, including assessing, diagnosing, and treating medical conditions and injuries.● Maintained accurate and detailed patient care reports and medical records, ensuring smooth continuity of care.

Johannesburg Area, South Africa

● Responding to emergency calls promptly and providing basic life support to patients before transporting them to a medical facility.● Assisted the paramedic and other medical staff in administering emergency medical care in accordance with standard protocols and procedures.● Provided first aid and basic life support to patients in non-emergency situations, such as during transport or at public events.● Maintained accurate and detailed patient care reports and medical records to ensure continuity of care.

Basic And Intermediate Icd-10 Coding Course, Medical Insurance Coding Specialist/Coder, 100

Basic Icd-10 Coding, Icd-10 Coding

Basic ICD-10 Coding Course

Inseta Middle Management Development Programme, Business Administration And Management, General

Basic Icd 10 Coding, Health/Health Care Administration/Management

Technical Claims Processes, Claims

Ambulance Emergency Assistant, Health/Health Care Administration/Management

For Verification please contact Hurt Tactical: Their details are as follows: Hurt Tactical 011 083 6313 https://www.hurt-tactical.com.

Basic Ambulance Assistant, Health/Health Care Administration/Management

For Verification please contact Hurt Tactical: Their details are as follows: Hurt Tactical 011 083 6313 https://www.hurt-tactical.com.

Matric, Matric

Matric Qualification