Nontokozo Nkosi
Claim Assessor
Northriding
Summary
Experienced Funeral Claims Assessor with expertise in evaluating and managing complex insurance claims. Skilled in ensuring compliance with best practices and regulations, reviewing documentation, and identifying potential risks. Proficient in resolving queries, maintaining accurate records, and delivering professional service. Adept at collaborating with teams and clients to enhance operational efficiency and customer satisfaction. Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty.
Overview
8
8
years of professional experience
Work History
Risk & Funeral Claims Assessor
FNB - Life Insurance (Bank City)
3 2015 - 2 2024
- Evaluate Funeral and Critical Illness Claims: Review and assess funeral claim plans and the critical illness component, including requesting and verifying necessary documentation for evaluation.
- Ensure Compliance: Adhere to organizational best practices and legislative requirements during the assessment process.
- Manage Complex Claims: Accurately assess, investigate, and validate high-value or complex long-term insurance claims in alignment with organizational goals, objectives, and standards.
- Handle Queries Efficiently: Take ownership of customer and branch queries, ensuring timely and effective resolution.
- Mitigate Risks: Identify and escalate risks, including fraudulent activity and non-disclosure, to minimize potential issues.
- Continuous Improvement: Regularly assess performance, seek feedback, and request training to enhance skills and knowledge.
- Provide Professional Service: Deliver exceptional service to customers and branches through both telephone and written communication.
- Support System Development: Assist with system and process improvements, including testing new system changes related to the assessment process
- Retrieved claim records to verify policyholder information and coverage before processing claims.
- Examined claim evidence against company guidelines and procedures to determine suitable outcomes for submitted claims, informing approval or rejection decisions.
- Sought missing information and clarifications from clients to facilitate claim progression and settlement, recording provided data for future reference.
- Collected evidence through investigations, verified documentation from claim submissions and opened new cases in company systems to initiate claim processing activities.
- Assisted colleagues in investigating and troubleshooting problem claims, using expert knowledge to find and fix problems.
- Delivered formalised, on-the-job training for junior colleagues in claim handling, fraud detection and settlement, amplifying department's skills.
Call Centre Agent
FNB - Life Insurance (Bank City)
09.2014 - 03.2015
- Manage Complex Issues: Escalate intricate issues to the appropriate departments for resolution.
- Client Relationship Management: Develop and maintain strong relationships with clients, ensuring satisfaction and retention.
- Content Marketing: Create and implement comprehensive content marketing plans to enhance brand visibility.
- Inbound Marketing Strategies: Design and execute customized inbound marketing strategies to attract and engage potential leads.
- Lead Generation Campaigns: Set up and manage effective lead generation campaigns to drive growth.
- Data Analysis: Conduct detailed data analysis to optimize marketing strategies and improve performance.
- Email Marketing: Design and implement targeted email marketing workflows to nurture leads and retain clients.
- Performance Reporting: Provide clients with regular reports and performance metrics to demonstrate the success of marketing efforts.
- Campaign Collaboration: Work closely with clients to ensure the successful execution of marketing campaigns.
- Claims Inquiries: Handle calls and address claims-related inquiries promptly.
- Broker/Client Support: Attend to broker and client queries, articulate company products and services, and provide necessary support.
- Broker Liaison: Coordinate with broker consultants to address and resolve issues.
- Internal Team Support: Offer assistance to internal teams as needed to support organizational objectives.
- Product Education: Share information with customers and brokers to enhance their understanding of products.
- Report Creation: Generate reports and data extracts for brokers as requested
- Maintained detailed product knowledge to competently and expertly advise customers.
- Recorded details from customer communications on CRM.
- Applied correct hold and transfer procedures, consistently keeping call times within timeframe target.
- Dealt with complex customer complaints professionally and politely, resolving issues with favourable solutions.
- Increased customer satisfaction by offering friendly, helpful and informative customer service.
- Followed up customer calls with further information or instructions when necessary.
- Collaborated with other call centre professionals to improve customer service.
Administrator
ABSA (Watloo Pretoria)
02.2007 - 05.2013
- Review Credit Card Applications: Receive and evaluate credit card applications, ensuring completeness and accuracy of all required documents and information.
- Verify Applicant Information: Confirm applicants' personal details, employment information, credit history, and income to assess creditworthiness.
- Data Entry: Accurately and efficiently input applicant data into the company's credit card application system, adhering to established procedures.
- Conduct Background Checks: Perform background checks, including credit bureau reports, to evaluate financial stability and creditworthiness.
- Customer Communication: Address missing or inconsistent information on applications by contacting customers to request additional documentation as needed.
- Resolve Application Issues: Collaborate with credit card issuers and underwriters to address and resolve any discrepancies or concerns, providing timely and accurate information.
- Maintain Records: Keep detailed and confidential records of all credit card applications, ensuring data security and accuracy.
- Stay Informed: Remain updated on industry trends, regulations, and compliance requirements related to credit card applications.
- Support Sales Team: Work with the sales team to promote credit card products and facilitate a smooth application process for customers.
- Administered physical and digital filing systems, keeping records well-organised and easily retrievable for team members.
- Liaised directly with customers to meet needs and maintain satisfaction.
- Set up new files and assigned tracking numbers.
- Managed client communications by answering phones and corresponding through email.
Education
Diploma - Project Management
The Independent Institute of Education
Pretoria, GP 04.2001 -
Certificate - Call Centre
Zakhele College
Pretoria, GP 04.2001 -
Matric - High School
Ekwazini Secondary School
EMpumalanga, MP 04.2001 -
Skills
Funeral Planning
Retirement Planning
Life Insurance Planning
Education Planning
Portfolio Balancing
Financial Advisory
Marketing & Sales
Telephone Etiquette
Strategic Management
Fraud prevention
Regulatory compliance
Research skills
Project review
Technical knowledge
Written and verbal communication
Customer Service
Computer literate
References
Available on Request
Languages
IsiZulu
English
Upper intermediate (B2)
Afrikaans
Intermediate (B1)
Tswana
Intermediate (B1)
Timeline
Call Centre Agent
FNB - Life Insurance (Bank City)
09.2014 - 03.2015
Administrator
ABSA (Watloo Pretoria)
02.2007 - 05.2013
Diploma - Project Management
The Independent Institute of Education
04.2001 -
Certificate - Call Centre
Zakhele College
04.2001 -
Matric - High School
Ekwazini Secondary School
04.2001 -
Risk & Funeral Claims Assessor
FNB - Life Insurance (Bank City)
3 2015 - 2 2024