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elnet hough

@elnethough

I manage high-volume medical billing and claims for specialist healthcare practices.

South Africa
Message

I manage end-to-end medical billing at Specialist Integrated Medical Bureau for three anaesthetist practices, as well as Gynaecology, Dental and Audiology practices. I process approximately 900 medical aid claims per month, from theatre-list review and quotations through to claim capture and coding validation.

I investigate rejected and short-paid claims, manage resubmissions, liaise with medical schemes, and support accounts receivable, reconciliations and debt management. I use GoodX, Elite Billing and Microsoft Excel to maintain accurate reporting and improve billing processes.

Experience

Work history, roles, and key accomplishments

SS
Current

Medical Billing & Claims Specialist

Specialist Integrated Medical Bureau (SIMS)

Jun 2023 - Present (3 years 3 months)

Manage end-to-end medical billing for three anaesthetist practices, including claim capture, coding validation, corrections, resubmissions, and payment follow-up. Process approximately 900 medical aid claims per month and liaise with major South African medical schemes.

SE

Guesthouse Manager

Self Employed

Jan 2017 - Dec 2019 (2 years 11 months)

Managed a guesthouse, overseeing daily operations and guest services.

EN

Personal Assistant / Receptionist

ENSafrica

Jan 2010 - Dec 2014 (4 years 11 months)

Provided administrative support and receptionist duties at a law firm.

VA

Secretary / Receptionist

Venter Attorneys

Jan 2008 - Dec 2010 (2 years 11 months)

Performed secretarial and receptionist duties at a law firm.

DJ

Secretary / Receptionist

Department of Justice

Jan 2003 - Dec 2008 (5 years 11 months)

Provided secretarial and receptionist support at the Department of Justice.

DJ

Filing Clerk / Data Capturer

Department of Justice

Jan 2002 - Dec 2003 (1 year 11 months)

Handled filing and data capture duties at the Department of Justice.

Education

Degrees, certifications, and relevant coursework

OA

Oxbridge Academy

Medical Secretary N4, Medical Secretary

Completed the Medical Secretary N4 qualification.

GC

Goodwood College

Matric, General

Completed secondary education and obtained the Matric certificate.

Tech stack

Software and tools used professionally

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