OLEBOGENG OLEVER MABELA
Claim Assessor And Claim Validator
Alexandra
Summary
A dedicated and results-driven professional with extensive experience in the insurance industry. Strong background in claims assessment, fraud prevention, and customer service. Demonstrated expertise in identifying and investigating fraudulent claims, ensuring compliance with policies, and providing exceptional service to stakeholders. Excellent communication skills, with keen attention to detail and a commitment to achieving high standards. I am currently seeking a challenging position to apply my skills and contribute to organizational success.
Overview
15
15
years of professional experience
6
6
Certifications
Work History
Funeral Claim Administrator( Maternity Releaver)
Akani Pension Fund and Administrator
02.2025 - 06.2025
- Collaborated with other departments to ensure seamless coordination in addressing client needs and concerns.
- Improved customer satisfaction ratings by providing timely and accurate information on claim status.
- Participated actively in ongoing professional development opportunities to stay current on industry trends and best practices within the field of Claims Administration.
- Ensured compliance with all applicable regulations governing the claims process, avoiding potential legal complications or penalties for noncompliance.
- Conducted comprehensive investigations to verify the validity of claims, minimizing instances of fraud.
- Assisted policyholders in understanding their coverage options while compassionately handling emotionally charged situations surrounding loss events.
- Implemented quality control measures, resulting in fewer errors and increased accuracy in claim processing.
- Resolved complex claim issues for successful settlements, utilizing expert negotiation skills.
- Investigated, evaluated and adjusted multi-line claims in accordance with standards and laws.
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
- Improved customer satisfaction scores through application of superior conflict resolution and problem-solving skills.
- Improved office operations by automating client correspondence, record tracking and data communications.
Claim Assessor
SanlamSky – Houghton
08.2015 - 12.2024
- Assess and process claims in accordance with company procedures and insurance policy guidelines.
- Reject invalid claims and ensure all claims comply with SLA and SOP standards.
- Maintain an error rate of less than 0.5% by ensuring accurate claim capturing and processing.
- Provide real-time feedback to clients regarding the status of their claims.
- Investigate fraudulent claims, notify clients of outstanding documentation, and initiate external investigations as necessary.
- Build and maintain relationships with stakeholders, addressing their insurance needs and providing excellent service.
- Identified fraudulent claims with comprehensive investigations, minimizing company losses and maintaining integrity in the claims process.
- Contributed towards continuous improvement initiatives within the department, identifying areas of potential growth or optimization opportunities.
- Researched claims and incident information to deliver solutions and resolve problems.
- Interviewed claimants and witnesses to gather factual information.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
Indexing Clerk
SanlamSky – Houghton
02.2012 - 07.2014
- Maintained an organized record of all documents for timely retrieval and filing.
- Categorized, indexed, and filed documents based on content and purpose.
- Managed all user requests related to document positioning, retrieval, and filing.
- Ensured proper documentation and archival systems were followed to maintain accurate records.
- Helped with paperwork inquiries and ensured document availability.
- Enhanced filing efficiency by streamlining document management processes.
Shop Assistant (Casual)
Toys R Us
01.2010 - 12.2010
- Assisted customers with product selection and inquiries, ensuring a positive shopping experience.
- Maintained the store’s inventory by restocking shelves and ensuring products were readily available.
- Processed transactions accurately and assisted with cashier duties during peak hours.
- Managed returns and exchanges, providing solutions to customers in line with store policies.
- Ensured store cleanliness and organization.
- Supported staff in daily operations to meet sales goals and achieve customer satisfaction.
Education
Fundamentals of Fire Engineers - fire investigation course
Institution of Fire Engineers
08-2024
Diploma - Criminal Justice
Lyceum College
Higher Certificate - Criminal Justice
University of Johannesburg
Programme - Forensic and Investigation Auditing (NQF Level 6)
Unisa
NQF Level 4 Long Term Insurance (FAIS 140 Credit) - undefined
SanlamSky Learnership
Grade 12 - undefined
Moratwe High School
Certificate From Crime Scene To Court
Forensic And Firearm Training Academy
Victoria West, South Africa04-2024
Skills
Microsoft office
Claims processing
Policy interpretation
Confidentiality
Follow-up skills
Customer communication
Problem-solving
Customer service
Problem-solving ability
Team collaboration
Active listening
Multitasking Abilities
Certification
Certificate (From Crime Scene to Court), Forensic and Firearm Training Academy
References
- Kwena, Manaka, Claims Manager, kwenaman@sanlamsky.co.za, 0839655706, SanlamSky
- Richard, Mabitsela, Claims Department Team Leader, richardm@sanlamsky.co.za, 0836641095, SanlamSky, Reason for Leaving at Sanlam: Seeking for the new Challenges as I felt I was not growing
- Thabo, Mokgotsi, Senior Billing Administrator, mokgotsi@neighbourfuneral.com, 0726686672
Disclaimer
I hereby declare that the information provided is true and correct to the best of my knowledge and belief. Olebogeng Olever Mabela
Travel and read nobels
I am very energetic person who is willing to learn and help others, always make sure that I achieve more than what is expected from me, all am asking for is an opportunity to show case my skill and talent, I am very focused, discipline person and details orientated person,I am down to earth person, I am ready for any challenge.
Timeline
Funeral Claim Administrator( Maternity Releaver)
Akani Pension Fund and Administrator
02.2025 - 06.2025
Claim Assessor
SanlamSky – Houghton
08.2015 - 12.2024
Indexing Clerk
SanlamSky – Houghton
02.2012 - 07.2014
Shop Assistant (Casual)
Toys R Us
01.2010 - 12.2010
Diploma - Criminal Justice
Lyceum College
Higher Certificate - Criminal Justice
University of Johannesburg
Programme - Forensic and Investigation Auditing (NQF Level 6)
Unisa
NQF Level 4 Long Term Insurance (FAIS 140 Credit) - undefined
SanlamSky Learnership
Grade 12 - undefined
Moratwe High School
Fundamentals of Fire Engineers - fire investigation course
Institution of Fire Engineers
Certificate From Crime Scene To Court
Forensic And Firearm Training Academy
Similar Profiles
Keneilwe LekalakeKeneilwe Lekalake
Benefits Administrator at Akani Retirement Fund AdministratosBenefits Administrator at Akani Retirement Fund Administratos
Keamogetswe PhofediKeamogetswe Phofedi
Receptionist Tamp at Government Employees Pension FundReceptionist Tamp at Government Employees Pension Fund
William Quinn MarceauxWilliam Quinn Marceaux
Membership Analyst at Louisiana Sheriffs' Pension and Relief FundMembership Analyst at Louisiana Sheriffs' Pension and Relief Fund
Oratile Jean MabalaneOratile Jean Mabalane
B2B Sales Consultant at CartrackB2B Sales Consultant at Cartrack
LOUISE HURREYLOUISE HURREY
Receptionist at Cathedral Lodge and Golf ClubReceptionist at Cathedral Lodge and Golf Club