Lerato Zwane - RCA Agent / Client Services (2022 – Current) - AFROCENTRIC

Summary

Dynamic RCA Agent with a proven track record at Afrocetric, excelling in root cause analysis and service recovery. Adept at resolving escalations and enhancing client satisfaction through effective communication and quality assurance. Skilled in claims investigation and SLA management, fostering a culture of continuous improvement and member empowerment.

Overview

4

years of professional experience

Work History

RCA Agent / Client Services

AFROCENTRIC

02.2022 - Current

Investigating and resolving service failures through detailed Root Cause Analysis (RCA) to identify the origin of issues.
Conducting outbound calls to members to investigate potential negative NPS ratings and assess service experience.
Evaluating recorded and live calls to ensure compliance with company policies, procedures, and quality standards.
Coaching agents by identifying performance gaps and improvement opportunities.
Conducting and facilitating workshops based on service failure trends identified through RCA findings.
Liaising and working closely with business unit leadership to highlight service gaps and recommend enhancements.
Rolling out training sessions using case studies derived from RCA investigations.
Drafting escalation and feedback reports on a case-by-case basis for management review.
Handling escalations, complaints, and compliments while ensuring SLA adherence.
Educating members on products, benefits, and claims processes.
Handle inbound calls from members and brokers regarding claims, membership, benefits, and finance-related queries.
Capture, investigate, reverse, and reprocess claims in accordance with scheme rules, policies, and QA standards.
Conduct detailed problem-solving and claims investigations to resolve member issues effectively.
Handle escalations, customer complaints, and compliments professionally.
Maintain Service Level Agreements (SLA) through effective query management and follow-ups.
Educate members on various Bonitas products and benefits, ensuring clarity and understanding.
Ensure effective follow-up on member and broker queries.
Handle membership and finance-related enquiries.
Conduct outbound calls when required for follow-ups, investigations, and service recovery.
Apply strong business writing skills in correspondence, case notes, and reports.
Ensure adherence to Quality Assurance standards at all times.
Promote self-help services and social media platforms to empower members and reduce call volumes.

Education

Cosmotology

Erkurhuleni West College - Cosmetology [Completed] 2011

Germiston, South Africa

04.2001 -

Skills

Clients & member services

Claims capturing, investigation, reverse &reprocessing

Escalations & ComplaintsresolutionRoot cause analysis (RCA) &Service RecoveryQuality Assurance & ComplianceMonitoringSLA Management & Follow up

REFERENCE

Nompumelelo Khumalo - Manager
011 671 2490 / 061 486 6698