LEBOGANG SIPHESIHLE SELOBANE
Claims Consultant
Johannesburg
Summary
Experienced with managing intricate insurance claims and resolving disputes efficiently. Utilizes deep knowledge of policy and regulatory guidelines to ensure compliance and fair settlements. Track record of maintaining client trust and achieving operational excellence.I have Successfully managed numerous claims while ensuring compliance with regulations and improving client satisfaction. Demonstrated problem-solving and analytical abilities in every aspect of claims processing.
I have developed strong analytical and customer service skills within fast-paced insurance environment. Proficient in evaluating claims, resolving disputes, and maintaining accurate records. Seeking to transition into new field, leveraging these skills to contribute effectively in different professional domain.
Overview
6
6
years of professional experience
2068
2068
years of post-secondary education
Work History
Insurance Claims Consultant
4-Sure Technologies Solutions
03.2022 - 06.2024
- Handling and settling claims within stipulated time
- Strategic -relationship/partnership-building skills-listen attentively, solve problems
- Creatively, and use tact and diplomacy to find common ground and achieve win-win outcomes
- Negotiating with various claims assessors and other related service providers
- Providing clients/brokers with the highest standard of services
- Ensuring diary system is always implemented and adhered to
- Attending to payment request
- Timely answering emails and telephonic calls
- Proper time keeping and task prioritization/management
- Ensure resolution of queries and complaints speedily
- Ensure a pleasant claim experience
- Receive claim and facilitate resolution
- Providing continuous feedback to the broker
- Receive claims after registration and make sure all details are captured
- Check claims history on policy to confirm previous similar losses
- Responsible for proactive identification of fraudulent cases and recovery potential
- Investigate the merit of the claim against the information
- Appoint specialist i.e., Incident Manager / Service provider
- Negotiate and authorize settlement of claims
- Quantify the loss - determine basic, limited item identification (value and proof of ownership)
- Review equivalent replacement value from quotation provided by the client/ supplier
Customer Care Service
Malas Drive Style Centre
01.2021 - 12.2021
- Attend to customer queries
- Assist with create quotations for customer and confirming Tyre sizes and availability
- Answer incoming calls and respond to emails
Learnership (Customer Service Representative)
Startek South Africa (Pty) Ltd
01.2019 - 12.2020
- Review equivalent replacement value from quotation provided by the client
- Answer calls and respond to emails
- Handle customer enquiries both over email or phone call
- Identify and escalate priority issues, Credit customers
- Troubleshoot devices
Learnership-Administrative Clerk Intern
Helen Joseph Hospital
01.2018 - 12.2019
- Answer and transfer calls to other departments
- Book appointments for Patients
- Open files for first visits using PAAP system or manual, attend to admission, transfer, and discharge of patient
Education
Class of Business-Commercial Lines
Moonstone
04.2001 - 01.2024
Handle a range of customer complaints in a Contact Centre and BPO - eLearning Online course
Speccon Holdings
05-2023
Coaching - eLearning Online course
Speccon Holdings
05-2023
Crime Scene investigation and reporting - undefined
Forensic and Firearm Training academy
Financial Literacy-Be Money Wise
University of Johannesburg
04.2001 -
Basics of Compliance Management
Alison
08-2024
Contact Centre Operations
Services SETA
11-2019
Skills
Data Analysis
Training and Development
Staff Support and Motivation
Computer Skills
Relationship Building
Problem Solving
Customer service
Problem-solving abilities
Data entry
Teamwork skills
Excellent communication
Decision-making
Claims processing
Critical thinking
Attention to detail
Timeline
Insurance Claims Consultant
4-Sure Technologies Solutions
03.2022 - 06.2024
Customer Care Service
Malas Drive Style Centre
01.2021 - 12.2021
Learnership (Customer Service Representative)
Startek South Africa (Pty) Ltd
01.2019 - 12.2020
Learnership-Administrative Clerk Intern
Helen Joseph Hospital
01.2018 - 12.2019
Class of Business-Commercial Lines
Moonstone
04.2001 - 01.2024
Financial Literacy-Be Money Wise
University of Johannesburg
04.2001 -
Crime Scene investigation and reporting - undefined
Forensic and Firearm Training academy
Handle a range of customer complaints in a Contact Centre and BPO - eLearning Online course
Speccon Holdings
Coaching - eLearning Online course
Speccon Holdings
Basics of Compliance Management
Alison
Contact Centre Operations
Services SETA
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