AYANDA MATSIDISO KUBHEKA
Centurion
Summary
Detail-oriented Business Claims Advisor with strengths in claims assessment and validation. Manages client communications and resolves claim-related issues to enhance customer satisfaction. Collaborates with internal teams to ensure accurate and timely claim processing. Dedicated Business Claims Advisor skilled in delivering exceptional customer service. Provides clear guidance on claims policies and procedures, ensuring clients make informed decisions. Facilitates smooth communication between stakeholders to expedite claim settlements. Motivated professional demonstrating strengths in claims processing and customer relationship management. Adapts to dynamic environments through effective communication and problem-solving skills. Committed to supporting team goals and enhancing operational efficiency. Driven professional with excellent customer service experience and background managing complex claims. Strong organisation skills and high level of attention to detail.
Overview
9
9
years of professional experience
Work History
Business Claims Advisor
Telesure Group Services
02.2024 - Current
- Handling business insurance claims by assessing, validating, and processing claims efficiently, ensuring adherence to Telesure Group Services' policies and standards.
- Providing exceptional customer service by addressing client inquiries, resolving claim-related issues, and offering professional guidance throughout the claims process.
- Liaising with internal teams and external stakeholders to coordinate claim settlements, ensuring smooth communication and timely resolution of claims.
- Conducting thorough investigations of claims by gathering and analyzing relevant information, ensuring accuracy and compliance with Telesure Group Services' legal and regulatory requirements.
- Updating clients regularly on the status of their claims, and maintaining open lines of communication to enhance customer satisfaction and transparency.
- Advising clients on claim policies and procedures, offering clear explanations on coverage, excess payments, and documentation requirements to ensure informed decisions.
- Reviewing and verifying claim documents for completeness and accuracy, ensuring all necessary information is captured and recorded in line with company protocols.
- Identifying potential fraud risks by analyzing claim patterns and red flags, and escalating suspicious claims for further investigation to protect Telesure Group Services from financial losses.
- Collaborating with the finance and underwriting departments to ensure claims are processed accurately and within budget, contributing to the financial integrity of Telesure Group Services.
Motor Claims Advisor
MiWay Insurance
07.2021 - 01.2024
- Handling motor insurance claims for MiWay Insurance, ensuring accurate documentation, verification, and timely processing of claims to provide seamless customer experiences.
- Liaising with customers by addressing queries, providing claim updates, and offering professional advice on the claims process, ensuring clarity and satisfaction.
- Investigating motor claims by gathering relevant information, assessing damage reports, and collaborating with assessors to determine claim validity and ensure fair settlements.
- Collaborating with repair shops and service providers, ensuring quick repairs and replacements, and negotiating costs to reduce claim payouts while maintaining customer satisfaction.
- Providing expert guidance to customers on motor insurance policies, coverage options, and claims procedures, helping them make informed decisions, and enhancing customer loyalty to MiWay Insurance.
- Resolving complex claims issues by identifying discrepancies, coordinating with internal teams, and finding effective solutions to ensure fair and timely resolutions.
- Maintaining accurate records of all claims and customer interactions, ensuring compliance with MiWay Insurance's standards and regulatory requirements for auditing and reporting purposes.
Drivable Advisor
MiWay Insurance
02.2018 - 06.2021
- Assessing vehicle damage and determining drivable conditions in line with MiWay Insurance's guidelines, ensuring accurate evaluations for repairability and claims processing.
- Providing expert advice to clients on drivable and non-drivable claims, offering clear guidance on the next steps for repairs or replacements while maintaining excellent customer service.
- Coordinating with repair service providers to facilitate the smooth repair of damaged vehicles, ensuring timely and cost-effective service in alignment with MiWay Insurance's standards.
- Handling client inquiries and concerns by resolving issues related to drivable claims, ensuring customer satisfaction through prompt and professional communication.
- Managing claims documentation by ensuring all necessary paperwork is accurately completed and submitted within MiWay Insurance's system for efficient claims processing.
- Collaborating with internal teams at MiWay Insurance to streamline claim assessments and repair processes, enhancing overall efficiency and client satisfaction.
- Staying informed on industry standards and updates related to vehicle repairs and insurance claims, ensuring MiWay Insurance's practices remain compliant and competitive.
Claims - Learnership
MiWay Insurance
02.2017 - 02.2018
- Assisting customers with claims processing as a learner by guiding them through the claim submission process, ensuring all required documentation is provided for a smooth and timely resolution at MiWay Insurance.
- Investigating claim details by learning to review submitted information, verifying coverage, and coordinating with relevant departments to ensure accurate assessments and decisions.
- Providing excellent customer service by responding to inquiries via phone and email, learning to address concerns promptly, and offering clear, helpful guidance throughout the insurance claim process.
- Collaborating with the claims team at MiWay Insurance, working closely as a learner to resolve discrepancies and ensure that claims are processed efficiently and within regulatory guidelines.
- Managing data entry tasks by accurately inputting claim information into the system, ensuring all records are up-to-date and accessible for future reference and audits while developing skills in data accuracy.
- Tracking claim statuses by monitoring progress, updating customers on the status of their claims, and ensuring timely follow-ups to maintain customer satisfaction as part of the learning process.
- Supporting the team in administrative tasks such as organizing files, maintaining records, and assisting in day-to-day operations to ensure smooth workflows, while gaining valuable hands-on experience in insurance operations.
Education
Moonstone Business School Of Excellence
01-2023
INSETA
01-2017
Ndlela Secondary
01-2015
Skills
- Claims assessment
- Customer relationship management
- Claims processing
- Documentation accuracy
- Policy interpretation
- Problem solving
- Effective communication
- Team collaboration
- Client engagement
- Customer service excellence
- Strong work ethic
- Clear communication
- Technical troubleshooting
- Product knowledge
Referrences
- Acting Team Manager | Thandeka Mtshali
[Telesure]
Contact Number: +27 64 398 6887 - Claims QA | Louanne Terreblanche
[MiWay]
Contact Number: +27 71 991 9044 - Team Manager | Sashentha Kuni
[MiWay]
Contact Number: +27 76 520 2975
Timeline
Business Claims Advisor
Telesure Group Services
02.2024 - Current
Motor Claims Advisor
MiWay Insurance
07.2021 - 01.2024
Drivable Advisor
MiWay Insurance
02.2018 - 06.2021
Claims - Learnership
MiWay Insurance
02.2017 - 02.2018
Moonstone Business School Of Excellence
INSETA
Ndlela Secondary