Dylon Solomons
Hanover Park
Summary
Dynamic professional with a proven track record at Foundever SA, excelling in medical claims processing and client education. Adept at problem-solving and conflict resolution, I consistently deliver results while maintaining strong customer relationships. My attention to detail and commitment to excellence drive efficiency and enhance team performance.
Overview
10
10
years of professional experience
Work History
Medical Claims Specialist
Foundever SA
Cape Town
01.2024 - 07.2025
- Processed medical claims using advanced software systems and tools.
- Reviewed documentation for accuracy and compliance with regulations.
- Communicated with healthcare providers to resolve claim inquiries effectively.
- Collaborated with team members to improve claim processing workflows.
- Maintained up-to-date knowledge of insurance policies and industry changes.
- Educated clients on claim procedures and requirements for submission.
- Assisted in training new staff on claims processing best practices.
- Verified patient eligibility for medical claims and determined benefit coverage.
- Identified incorrect charges on invoices by comparing them against contracts and fee schedules.
- Provided guidance and training to staff members regarding billing practices and procedures.
- Reviewed denials, rejections, and underpayments from insurance carriers.
- Conducted research into complex medical coding issues to ensure proper reimbursement.
- Analyzed health care costs and identified potential areas of cost savings.
- Responded promptly to customer inquiries regarding claim status updates.
- Collaborated with other departments regarding changes to existing processes and procedures.
Flexi Time Coach
Fives Futbol
04.2015 - 12.2023
- Training the children in football by analyzing their performances
- Instructing the children on how to develop their skills and assisting with teaching new skills to enhance their performance
- Providing encouragement
Customer Service Specialist
Peermont Global PTY
Cape Town
05.2022 - 08.2023
- Assisted customers with inquiries and resolved issues promptly.
- Managed customer interactions through multiple communication channels effectively.
- Documented customer feedback and suggested improvements to management.
- Trained new staff on customer service protocols and best practices.
- Handled escalated complaints with professionalism and empathy.
- Maintained product knowledge to provide accurate information to customers.
- Maintained a high level of professionalism while interacting with customers via phone or email.
- Resolved customer inquiries, questions and concerns to consistently offer quality service and meet performance benchmarks.
- Provided assistance to customers in navigating website, placing orders, and resolving complaints.
- Collaborated with colleagues from other departments in order to resolve customer concerns quickly.
- Conducted regular audits to ensure adherence to regulatory standards and internal policies.
- Reviewed and updated risk management policies to align with industry regulations.
- Prepared detailed reports on risk assessments for senior management review and action.
- Reviewed risk management database reports for compliance and fraud prevention.
- Maintained risk identification programs to reduce potential losses from workers' compensation and general liability insurance issues.
- Constructed periodic surveys and inspections to comply with regulatory committees.
- Reported findings on risk exposures to senior executives and board of directors.
- Recommended state safety grants to prioritize use of available funds for identified risks.
Sales and Customer Service
Lead Capital Group PTY
10.2019 - 09.2021
- Several continuous months as number one sales agent in the entire company exceeded expectations and set record in first ever sales job
- Customer correspondence through E-mail
- Live Chat and social media
- Inbound and outbound calls
- Payments/ withdrawals for clients
- Technical support
Customer Service / Technical Support Agent
iiNet
03.2017 - 10.2018
- Liaise with clients telephonically relating to any queries regarding Wi-Fi and internet set up
- Liaise with clients telephonically regarding complaints
- Provide first call resolution to clients
- Capturing and cataloguing all customer interactions
- Following up on existing complaints to ensure that the complaints are resolved
- Provide excellent customer service
Education
Grade 12 - Afrikaans (Second Language), English (First Language), Life Orientation, Mathematical Literacy, Business Studies, Geography, History
Oaklands High School
Skills
- Computer Literate
- Excellent communication and interpersonal skills
- Conflict resolution
- Ability to read, speak, and interpret written instruction
- Excellent time management and organizational skills
- Excellent written and verbal communication skills
- Following instructions and procedures
- Adhering to principles and values
- Delivering results and meeting customer expectations
- Maintain records and archiving
- Energetic
- Willingness to help
- Success driven
- Hard working
- Willingness to learn and grow
- Customer relationship management
- Problem solving
- Training and mentoring
- Attention to detail
- Time management
- Influencing skills
Criminal History
None
References
- Foundered SA : Training and Team Managers.Muneebah Hermans : 0744673844Thandokazi : 0717843465
- IiNet, Dayne Boonzaier, Trainer and Senior Agent, 0836438553 / 0849494604 / 0614721544
- Fives Futbol, Bernard Manshon, Manager, 082 470 7361
- Lead Capital Group, Yaaseen Adams, Team Leader and Senior, 0817062823
- Peermont Global PTY, Jesse Fish, Manager, 0610642513
Key Performance Areas And Responsibilities
- Liaise with clients telephonically relating to any queries regarding Wi-Fi and internet set up
- Liaise with clients telephonically regarding complaints
- Provide first call resolution to clients
- Capturing and cataloguing all customer interactions
- Following up on existing complaints to ensure that the complaints are resolved
- Provide excellent customer service
- Several continuous months as number one sales agent in the entire company exceeded expectations and set record in first ever sales job
- Customer correspondence through E-mail
- Live Chat and social media
- Inbound and outbound calls
- Payments/ withdrawals for clients
- Technical support
- Training the children in football by analyzing their performances
- Instructing the children on how to develop their skills and assisting with teaching new skills to enhance their performance
- Providing encouragement
Personal Information
- ID Number: 970620 5228 086
- Dependents: None
- Health Status: Excellent
- Date of Birth: 06/20/97
- Gender: Male
- Nationality: South African
- Marital Status: Single
Languages
afr
Beginner
A1
Timeline
Medical Claims Specialist
Foundever SA
01.2024 - 07.2025
Customer Service Specialist
Peermont Global PTY
05.2022 - 08.2023
Sales and Customer Service
Lead Capital Group PTY
10.2019 - 09.2021
Customer Service / Technical Support Agent
iiNet
03.2017 - 10.2018
Flexi Time Coach
Fives Futbol
04.2015 - 12.2023
Grade 12 - Afrikaans (Second Language), English (First Language), Life Orientation, Mathematical Literacy, Business Studies, Geography, History
Oaklands High School