Nosipho Nxele
Claims Consultant
Roodepoort
Summary
Demonstrates strong analytical, communication, and teamwork skills, with proven ability to quickly adapt to new environments. Eager to contribute to team success and further develop professional skills. Brings positive attitude and commitment to continuous learning and growth.
Overview
8
8
years of professional experience
4
4
years of post-secondary education
Work History
Claims Consultant
ABSA
Johannesburg
06.2023 - Current
- Improved claims processing efficiency by streamlining workflows and implementing best practices.
- Reduced claim resolution time with thorough investigations and effective negotiation techniques.
- Developed customized solutions for unique client needs, taking into account individual circumstances while adhering to company guidelines.
- Collaborated with underwriters to establish accurate pricing models based on individual risk profiles.
- Maintained strong relationships with clients, fostering trust and loyalty through excellent communication skills.
- Facilitated smooth communication between all parties involved in the claims process – from clients to adjusters – resulting in efficient resolutions without undue delays or setbacks.
- Managed large caseloads effectively, prioritizing tasks to ensure prompt attention to urgent matters.
- Enhanced client satisfaction by providing timely updates on claim status and offering personalized support.
- Trained new hires on claims procedures, ensuring a seamless transition into their roles as Claims Consultants.
- Resolved complex claims, utilizing expert knowledge of policy coverage and industry regulations.
- Assisted clients in navigating insurance policies and understanding their benefits, promoting informed decision-making.
- Followed up with customers on unresolved issues.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
Liability Claims Representative
Bryte Insurance
Rosebank
09.2022 - 05.2023
- Streamlined interdepartmental communication, resulting in better coordination among teams handling different aspects of the claims process.
- Increased efficiency in the claims process by maintaining organized records and clear communication with all parties involved.
- Effectively managed time-sensitive tasks under pressure without compromising the quality of work or customer service.
- Contributed to the development of improved claims handling procedures for greater efficiency and effectiveness.
- Developed positive working relationships with external partners such as law enforcement agencies, medical providers, repair shops, and others involved in the claims process.
- Saved the company money through diligent fraud detection efforts during claim investigations.
- Focused on continuous professional development through participation in relevant industry seminars and workshops.
- Maintained compliance with industry regulations and company policies while processing complex liability claims.
- Achieved higher levels of customer satisfaction through empathetic listening and effective problem-solving skills.
- Improved customer satisfaction by promptly and accurately resolving liability claims issues.
- Expedited claim settlements by effectively negotiating with claimants, attorneys, and other stakeholders.
- Reduced company exposure to potential losses by conducting thorough investigations of each claim.
- Reviewed policy coverage terms carefully for accuracy when determining appropriate payouts on settled claims.
- Supported team members during periods of high workload, demonstrating strong collaboration skills and adaptability.
- Enhanced departmental performance by providing training and mentoring to junior Liability Claims Representatives.
- Managed a caseload of diverse liability claims, ensuring timely resolution and accurate documentation.
- Collaborated with legal counsel to successfully defend against litigation related to disputed liability claims.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Collaborated with internal departments and external vendors to resolve claims.
- Developed in-depth understanding of insurance policies and procedures.
- Verified client information by analyzing existing evidence on file.
- Maintained confidentiality of patient finances, records, and health statuses.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Determined appropriateness of payers to protect organization and minimize risk.
Recovery Technician
Bryte Insurance
02.2017 - 08.2022
- Optimized asset utilization for maximum recovery with meticulous record-keeping and data analysis.
- Ensured safety compliance by strictly adhering to established protocols during all recovery operations.
- Enhanced overall client satisfaction by consistently delivering high-quality results on time and within budget constraints.
- Established network shares and upgraded and configured hardware.
- Developed strong relationships with key stakeholders, including vendors, clients, and regulatory authorities involved in the asset recovery industry.
- Developed, implemented and operated network system infrastructure and procedures.
- Collaborated with team members to develop innovative solutions for complex recovery challenges.
- Conducted thorough assessments of damaged assets, accurately identifying salvageable components for potential reuse or resale opportunities.
- Assisted in training new technicians, sharing best practices and fostering a positive team environment.
- Treated clients and families with respect and dignity.
Education
NQF Level 5 - Short Term Insurance
Octomate
Johannesburg, South Africa 02.2023 - Current
NQF Level 6 - Occupational Risk Practioner
Felix Risk Training
Johannesburg, South Africa 06.2024 - Current
NQF Level 5 - Paralegal Studies
SA LAW School
Randburg, South Africa 02.2019 - 02.2020
NQF Level 4 - Short Term Insurance
BRC Compliance And Training
Johannesburg, South Africa 01.2017 - 02.2018
Skills
Claims analysis
Timeline
NQF Level 6 - Occupational Risk Practioner
Felix Risk Training
06.2024 - Current
Claims Consultant
ABSA
06.2023 - Current
NQF Level 5 - Short Term Insurance
Octomate
02.2023 - Current
Liability Claims Representative
Bryte Insurance
09.2022 - 05.2023
NQF Level 5 - Paralegal Studies
SA LAW School
02.2019 - 02.2020
Recovery Technician
Bryte Insurance
02.2017 - 08.2022
NQF Level 4 - Short Term Insurance
BRC Compliance And Training
01.2017 - 02.2018
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