Summary
Overview
Work history
Education
Skills
Technical Skills
References
Timeline
Generic

Lerato Penelope Pamela Zwane

Soweto,Gauteng

Summary

Dedicated call center professional with experience in medical aid member services, claims administration, quality
assurance, and root cause analysis. Proven ability to resolve complex member queries, manage escalations, and maintain
SLA and compliance standards across Bonitas.

Overview

15
15
years of professional experience

Work history

RCA Agent / Client Services

AFROCENTRIC
Roodepoort, Gauteng
2022.02 - 2026.04

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.
  • Rolling out training sessions using case studies derived from RCA investigations.
  • Handling escalations, complaints, and compliments while ensuring SLA adherence.
  • Educating members on products, benefits, and claims processes.
  • Handle outbound calls to 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.
  • 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 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.
  • Assisted clients in navigating the claims process, ensuring timely resolution of issues and optimal outcomes.

Placecol Skin Care Clinic — Beauty Therapist

Imbali beauty
Randburg, Gauteng
2012.02 - 2020.12
  • Facilitated a relaxing environment with calming aromatherapy techniques.
  • Improved client satisfaction by delivering personalised facial treatments.
  • Provided exceptional customer service, ensuring repeat client bookings.
  • Adapted beauty treatments to address individual client needs.

Skills Auditor

MNA Strategic Development —
Parktown North, Gauteng
2011.09 - 2011.11

Registered individuals and ensured accurate data capturing and verification

Education

Some College (No Degree) - Cosmotology

Erkurhuleni West College - Cosmetology [Completed] 2011
Germiston, South Africa

Skills

  • Investigating and resolving service failures
  • Investigate and find out where service failure started from
  • Create outbound calls to investigate potential negative ratings
  • Evaluating calls making sure policies and processes are followed correctly
  • Coaching agents for improvement opportunities
  • Conducting workshops based on service failure trends identified
  • Liaise and work closely with business unit leadership highlighting areas of enhancement
  • Roll out training using case studies from RCAs to staff highlighting areas requiring improvements
  • Draft escalation feedback report on a case-by-case basis for management review

Technical Skills

References


Nompumelelo Khumalo – Manager | 011 671 2490 / 061 486 6698

Timeline

RCA Agent / Client Services

AFROCENTRIC
2022.02 - 2026.04

Placecol Skin Care Clinic — Beauty Therapist

Imbali beauty
2012.02 - 2020.12

Skills Auditor

MNA Strategic Development —
2011.09 - 2011.11

Some College (No Degree) - Cosmotology

Erkurhuleni West College - Cosmetology [Completed] 2011
Lerato Penelope Pamela Zwane