1. Curriculum Vitae
Xannelle Nortje

2. PersonalDetails
First Name: Xannelle
Surname: Nortje
Identity No: 771109 0218 087
Date of Birth: 9 November 1977
Nationality: South African
Languages: English, Afrikaans
Residential Address: 20 Mimosa Mews
Cornelius Street
Weltevreden Park
Contact Details: Cell: 082 466 2169
Email: xannelle@gmail.com
Education
Last School Attended:  Westering High School, Port Elizabeth
Highest standard Passed:  Matric
Subjects Passed:  English
 Afrikaans
 Biology
 Home Economics
 Geography
 Mathematics
Other Qualifications  Financial Advisory and Intermediary
Services (FAIS). SAQA ID: 66613
63 Credits

3. Training and Competencies
Computer Skills:  Windows 7
 Microsoft Office 2010
 SharePoint Portal
 Avaya CMS (Telephony)
 Blue Pumpkin (Staff scheduling,
productivity tracking & trending)
Training:  Evolve Training – Management Course
 Conducting Disciplinary Enquiries
 Staff Performance Management
 Soft Skills
EmploymentHistory
Employer:  Medscheme Holdings (Pty) Ltd.
Service Term:  October 1998 to 2012
1998 – Claims Assessor:
 Capture of claim details, clinical codes & allocation of codes to associated tariffs.
 Investigating erroneous tariffs & correction thereof.
 Analysis of clinical relevancy to claims.
1999 – Call Center Agent:
 Telephonic assistance to scheme members and health care professionals.
 Provision of query resolution to members and healthcare professionals in accordance
with scheme and regulatory guidelines.
o Assuring actions are completed correctly the first time around and when
appropriate scheduling of follow up of related activities – deadline orientated.
2002 – Support Administration:
 Resolution of referred queries that required a higher skill set or specializes activities
such as:
o Claim assessing
o Reconciliations
o Query analysis and finding the root causes of the defects

4. o Sourcing and implementation of preventative measures to mitigate or prevent
defects from re-occurring – sustainable solutions customer focus based.
o Review ex-gratia request in accordance with clinical guidelines and presentation
of findings to the scheme committee members.
o Resolve escalated management and board of trustee members.
o Assist with scheme exit projects and processes.
2003 – Hospital Accounts Administration:
 Providing support to first contact centers
 Authorization of hospital admissions and procedures in accordance to clinical guidelines.
 Investigation of escalated queries from hospitals regarding short or non-payments in
accordance to scheme and clinical guidelines.
2004 – Call Center Agent: (Transferred from Port Elizabeth to Roodepoort)
 Telephonic assistance to scheme members and healthcare professionals.
 Query resolution based on scheme rules and clinical guideline.
2004 – TeamLeader:(Promoted to Team Leader: Fedhealth Specialized Support-Office)
 Managing staff productivity and compliance in accordance to service level agreements.
 Managing and enabling staff growth and wellbeing.
 Facilitate staff training and development.
 Ensure staff adherence to company policies and procedures and enforce when required
in accordance to company and regulatory guidelines.
Reporting:
 Extracting & compiling daily management reports detailing Hello Peter complaints and
query resolutions.
 Compiling staff productivity reports detailing successes, failures and corrective actions
taken to prevent further productivity & service failures.
 Monitoring & management of email queries and assignment of tasks to relevant staff.
 Ensure incorrect email submissions were filtered out prior to assigning tasks.
 Compiling of detailed monthly analysis of management reports.
 Reports included analysis of top 10 query categories for Fedhealth.
 Summary of queries received from the Council of Medical Schemes from various
disparate systems.
 Compiling a trend analysis of peak telephone call volumes and staff availability to
highlight capacity issues.
 Identify potential risks and formulate corrective measures to avoid financial implications
and present the findings to management.
Incentives
 Calculate monthly staff incentive amounts based on productivity, quality of work,
Performance Knowledge Assessments’ and turn-around times.
Business Processes:

5. During my period as Team Leader I identified various gaps in business processes and
workflows. I analyzed each area and implemented the corrective or improved procedures e.g.:
 Email submissions:
o Improved tracking of email responses, faster resolution time and even workload
distribution.
o Improved guidelines and standards in responding to members via email –
document standardization.
o Email target analysis
 Productivity reporting:
o Shared network drive creation and centralized one productivity report per
department. This enable central repository enabled us to view seven years’ worth
of trending to be performed if required. These reports helped me identify that
although we had no positive member growth, we had seen a substantial increase
in electronic correspondence. This motivated the need for further staff to manage
electronic correspondence.
 Disciplinaries:
o I was tasked with gathering all evidence and testimony and creating evidence
packs for presentation to the panel and observed format. Streamlining the
approved method enabled me to become the only person on my grade to
perform a disciplinary enquiry and achieve a 100% success rate in favorable
decisions.
2010 to 2011 – TeamLeader:(Team Leader: Bonitas Escalation Unit.)
Accountable for managing escalated queries from the Executive Committee, Council for Medical
Schemes, Public Media Queries, National Consumer Consortium, printed media, Bonitas Board
of Trustees and negative members.
Query resolution through standardized business processes.
ISO: 9001:2008
 Ensure compliance to ISO: 9001-2008 standards.
 Compiling daily statistics for queries originating from the various aforementioned parties
and summary presentation to management.
Workflow Management
 Prioritization of action items and task assigning to relevant specialists.
 Identify stalled queries and investigate the delay in resolution - assist in expediting the
process where needed.
 Identify absent staff and reassign outstanding tasks and allocate in order to maintain
SLA’s.
 Assist staff and other fellow staff members with complex queries or irate members.
 Prioritization of forwarded requests from senior management, fund management or
provide ad-hoc reports.
 Follow up on stagnated queries in other departments and enforcing compliance of
policies and procedures in order to expedite their resolution.

6.  Attend senior management meetings as well as related presentations on behalf of senior
management.
 Reviewing of correspondence to the Council of Medical Schemes to validate the
information provided and the finding are sound and within guidelines.
Claims Management
 Monitor stale claims waiting processing and claim validation, as well as the Approval for
payment in accordance to scheme rules and guidelines.
 Run a daily workshop with my staff to identify their challenges, inform them of new
guidelines and refresh them on policies and processes which are not being adhered to.
 Monitor Hello Peter complaints and identify high risk complaints. Escalate to senior
management where required.
 Log and follow up on calls logged to Product Development and Support for data extracts
or product issues.
Quality Assurance
 Investigate and compose root cause analysis for each service failure and present the
report to management.
 Evaluate quality of work according to company standards.
 Prepare and consolidate the weekly report for Senior Management.
Reporting
 Collating and presentation of monthly reports for the Executive Committee & Senior
Management
 Complaints -Analyze Hello Peter queries and calculate the conversion ratio and identify
the common service failures.
Coaching and Mentoring
 Conduct monthly one-on-ones with each staff member and identifies any shortcomings.
Provide the staff member with a roadmap to resolving their shortcomings.
 Consolidate the one-on-one results and presentation of staff progress.
 Short Term Incentive Forum member
Ad-hoc Duties
Business Specialist:
 Tasked often to manage crisis areas in the business where departments were failing to
meet their targets and SLA’s.
 Analysis of current challenges, identification and implementation of workable solutions
and processes that yielded tangible results.
 Conducting disciplinary enquires where policies and procedures need to be enforced.
 Mediate in conflict management for other departments when disputes break-down.
 Perform staff capacity planning for new business or shrinkage.
 Conduct formal interviews for job candidates and evaluate their skills in accordance to
the job specification.
Employer:  International SOS (MedFit Department)

7. Service Term:  January 2013 to Present
Operational Manager from 2013 till present
 Management of the MedFit operations and service delivery in accordance with client
contracts and expectations and in line with the established International SOS MedFit
systems, policies and procedures.
 Responsible for building and maintaining efficient delivery of services to allocated clients,
ensuring that systems and human resources are in place to meet the changing needs of the
business.
 Liaise and interact with the client’s direct operational contact persons to ensure services are
delivered as per contract and to build relationships.
 Function as a primary escalation point for clients on service delivery failures and to ensure
appropriate action is taken.
Quality and Complaint Management
 Pre-empt customer complaints and be the point of escalation for client issues and
complaints.
 Acknowledge client complaints within 2 hours on working days and manage the
investigation and response into the complaint, within 48 working hours. Escalate to the
Regional Head of Assistance, Deputy Medical Director, Medical Doctors or Nursing Manager
as required.
 Ensuring complaints are loaded on internal recording systems. Incidents logged by the
Assistant Operational Manager/Team Leader are signed off on and take the appropriate
action to prevent future reoccurrences.
 To escalate areas of concern or legal risk as and when identified.
 Ensure corporate requirement of call reviews and case audits are completed each month.
 Ensure corporate requirements of case and call review calibrations for Assistant Operational
Manager and Team Leader evaluations are completed on a monthly basis.
External Client Relationships
 Function as the first point of operational client interface for day-to-day escalations and
review of MedFit services.
 Attend or chair client conference calls weekly and monthly or as required at timeframes
suitable to our client’s time zones.
 Attend monthly Assistant Operational Manager/Team Leader conference calls with clients.
 Coordinate all aspects of delivery components to meet contract deliverables.

8. People & Internal Relationship Management
 Responsible for operational leadership of the allocated client teams and building an
effective, high performance team.
 Manage personnel issues of the team employees (Assistant Operational Manager and
Team Leader) allocated to your clients, including dealing with matters relating to employee
conduct, performance management, training needs and participating in performance
reviews.
 Collaborate with the Regional Head of Assistance, other MedFit Operations Managers and
Assistant Operations Manager to ensure optimal performance and retention of high
performance team employees.
 Collaborate with the Quality Assurance team to identify service quality issues and to
maximize the benefit received from training and quality initiatives to improve service
delivery.
 Work with the other key employees of the management team including medical managers
and ensure that there is open and constructive communication across the organization.
 Full liaison with the Provider Liaison Manager and the MedFit Occupational Health
Doctor/Nurse to ensure occupational healthcare cases are delivered on a day-to-day basis
with total understanding and commitment to client satisfaction and meeting the Key
Performance Indicators.
 Ensure that the MedFit Regional Head of Assistance, MedFit Deputy Medical Director and
Nursing Manager/Doctors are fully briefed on issues, which may affect the delivery of the
service.
Manage the implementation and compliance the Key Performance Indicators for the team
employees on a regular basis.
 Conduct regular communication with the Group Assistant General Manager, MedFit and
Regional Head of Assistance to ensure systems integration and efficiency.
Service Delivery
 Take part in the “on call” rotation system with the Assistant Operations Managers/Team
Leaders.
 Take responsibility for the overall service delivery of the MedFit cases for clients allocated to
you, particularly in relation to the application and monitoring of contractual requirements as
well as internal policies, procedures and standards.
 To drive and ensure all cases are handled with speed and excellence with emphasis on
meeting expectations on Key Performance Indicators defined as per the Client per contract.
 To ensure that services provided to the Client’s employees fall under the scope of the
contract and that additional costs are identified and approved by Client before issuing a
guarantee of payment.
 Assist the Assistant Operations Managers/Team Leaders and /or Regional Head of
Assistance to compile records and statistical information both internally & externally where
appropriate.
 Inform and agree on course of action with Assistant Operations Manager/Team Leaders and
or Regional Head of Assistance with regards to any material issues relating to:
o Performance failure
o Non-compliance or breach of SOS code of Conduct
o Violations of Standard Operations Procedure
 Establish and maintain effective relationships with both internal and external customers and
providers.

9.  Attend client meetings as required.
 Involvement with new client implementations and roll outs as required.
 Manage the relationships with new and existing Medical Providers.
 To provide after-hours on call support to Customer Service Executives/Assistance Centre for
difficult client queries.
Financial
 Maintain daily billing schedule and ensure complete and maximum MedFit case fees billed
per allocated client billing protocol per month immediately.
 Maintain Prague billing queries to Operations to a maximum of 10% per invoice processed.
 Escalate to relevant stakeholders to ensure Provider invoices are paid timeously.
 Assist Business Development Managers where appropriate with the development and/or
maintenance of new/existing client's billing procedure.
Process Management
 Design, draft and reengineer operations processes to enhance delivery efficiency and
oversee the management of and compliance of service delivery to the processes and client
contracts.
 Ensure that standard operating procedures are up to date and in place.
 Escalate new requirements from existing clients to the MedFit Head of Operations to ensure
that correct action takes place.
 Engage with MedFit Medical Director to ensure client medical requirements are in line Key
Performance Indicators’ and the relevant client MedFit medical protocols.
 Implement and monitor quality control checks, metrics and compliance for reporting and
motoring performance standards.
 Monitor and manage the use of in-house IT Systems and external services in order to
maximize profitability of MedFit services without compromising the standard of service.
 Create succession plans for the key team employees in the MedFit team.
 Monitor and manage the use of in-house IT Systems and external services in order to
maximize profitability of MedFit services without compromising the standard of service.
Staff Management and Development
 Monitor and ensure that the Team Leader and Assistant Operational Manager’s allocate
workload appropriately
 Assist Regional Head of Assistance with recruitment, general management activities and
development of staff. (Address team member discipline and poor performance issues
 Complete Annual appraisal records
 Education of Team Member to create and aware of acceptable performance standards. (Key
Performance Indicators)
References are available on request.