Ruqaiya Gilbert
Team Leader
Johannesburg
Summary
Organized Team Leader builds positive rapport, inspire trust and guide teams toward achievement of organizational goals. Strong facilitator adept at working cross-departmentally with co-management and top-level leadership. Excellent trainer and mentor.
Overview
9
9
years of professional experience
1
1
year of post-secondary education
Work History
Administrative Team Leader
Iso Leso Optics
04.2023 - Current
- Increased customer satisfaction ratings by closely monitoring service quality standards and addressing any issues promptly.
- Assisted management in making informed decisions by providing accurate data analysis results through well-crafted reports.
- Effectively communicated complex data in clear and concise manner, leading to better-informed decision-making.
- Contributed to company-wide projects as needed, showcasing adaptability and versatility within report drafting.
- Developed custom templates for consistent report formatting and branding.
- Created, maintained and updated manuals, procedures, specifications and other documents.
- Maintained and updated installation instructions, training material and other technical documents.
- Reviewed, revised, modified and edited documents prepared by others.
- Compiled, organized and wrote help files to support end-users.
- Consulted with renowned experts on specific subject matters to verify accuracy, relevancy and usability of technical content.
- Selected photographs, drawings, sketches and charts to illustrate written materials.
- Worked closely with software engineers, product managers and other departments to determine accuracy and completeness of technical projects.
- Developed online tutorials and web-based training materials for software products.
- Observed in-progress operations to identify important steps for technical instructions.
- Educated employees on red flags and best practices for preventing fraudulent activities
- Reviewed internal controls and recommended improvements to mitigate risk of potential fraud incidents.
- Streamlined investigative processes with technology integration and data analytics tools, increasing productivity and accuracy.
- Analyzed large amounts of data to find patterns of fraud and anomalies.
- Tracked fraud cases and monitored trends to develop strategies for prevention.
- Collaborated with team members to discuss fraud trends and brainstorm methods to combat this type of crime.
- Enhanced website content by editing and proofreading articles for grammar, punctuation, and style.
- Selected and edited photos for use in diverse projects.
- Edited and reviewed content for grammar, spelling and punctuation.
- Collaborated with design, editorial and marketing departments to meet desired content goals.
Claims Assessor
Iso Leso Optics
12.2020 - 04.2023
- Capture paper claims according to industry standards and Medical Aid regulations.
- Assess all claims (paper/EDI) for completeness.
- Process claims with appropriate industry compliance rules and regulations.
- Effectively managed high-pressure situations during peak periods of claims activity while maintaining professional demeanor and efficient performance levels.
- Maintained accurate records of all claims assessed, facilitating easy retrieval when needed for audits or internal reviews.
- Escalated complex claims to senior management for further review, ensuring effective collaboration when approaching decision-making and fair outcomes.
- Streamlined claims assessment processes for increased efficiency through development of standardized templates and checklists.
- Ensured compliance with regulatory guidelines by staying up-to-date on industry standards and integrating them into daily workflows.
- Reduced turnaround time for claim settlements by prioritizing tasks, effectively managing caseloads, and collaborating with cross-functional teams.
- Enhanced customer satisfaction rates by promptly addressing inquiries and providing detailed explanations regarding claim decisions.
- Conducted post-claim evaluations to identify areas for improvement and potential training needs within teams.
- Identified fraudulent claims with comprehensive investigations, to minimize company losses and maintaining integrity of services offered.
- Consistently met or exceeded performance goals set by management, demonstrating commitment to excellence within the role of Claims Assessor.
- Researched claims and incident information to deliver solutions and resolve problems.
- Handled complaints and grievances using negotiating and problem-solving skills.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Assist in Call Centre duties and other areas when required
- Completed email audits for claim submissions on excel spreadsheets for our various contracts
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Provided support during internal and external audits, ensuring accurate representation of claims processed.
- Trained new employees on claims processing procedures, contributing to a well-prepared workforce.
- Followed up with customers on unresolved issues.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Managed workload and priorities to meet claims processing meet deadlines.
- Identified and reported potential fraud or abuse related to claims to protect system's integrity.
- Tracked and reported on claims processing metrics to aid senior management in making informed decisions.
- Complied with regulations and guidelines related to claims processing to maintain quality and adherence to standards.
- Assisted in onboarding of new claims processors to familiarize with company procedures, policies and processes.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
Call Centre Agent
Iso Leso Optics
01.2017 - 11.2020
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
- Worked well in a team setting, providing support and guidance.
- Skilled at working independently and collaboratively in a team environment.
- Organized and detail-oriented with a strong work ethic.
- Identified issues, analyzed information and provided solutions to problems.
- Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
- Managed client relationships through regular check-ins and updates on project progress.
- Reduced call wait times by efficiently managing call queues and prioritizing urgent requests.
- Collaborated with colleagues to share best practices and improve overall team performance.
- Enhanced communication skills through active listening, empathy, and clear verbal responses during customer interactions.
- Achieved success in retaining dissatisfied customers by offering targeted solutions and demonstrating empathy during challenging interactions.
- Escalated complex issues appropriately to management or specialized departments for further resolution when necessary.
- Kept up-to-date with company products, services, policies, and regulations to provide accurate information to callers at all times.
- Exceeded established performance metrics by demonstrating strong problem-solving abilities in addressing caller concerns quickly.
- Improved first-call resolution rates by effectively utilizing resources and available tools.
- Maintained strict adherence to data protection regulations when handling customer information, ensuring confidentiality and security at all times.
- Contributed to the development of training materials for new representatives, enabling quicker onboarding and integration into the team.
- Delivered outstanding results under high-pressure situations by maintaining composure during difficult calls or high-volume periods.
- Maintained high-quality service standards for all inbound calls, ensuring prompt and accurate assistance.
- Received recognition as an exemplary employee for consistently maintaining high levels of professionalism under pressure.
- Enhanced customer satisfaction by addressing inquiries and resolving issues in a timely manner.
- Developed rapport with customers while maintaining a professional tone throughout conversations, resulting in higher satisfaction scores.
- Resolved complaints to satisfy customers and encourage future transactions.
- Asked fact-finding questions to determine customer needs and expectations and recommended specific products and solutions.
- Answered phone with friendly greeting to create positive inbound calling experience for customers.
- Handled high volume of inbound calls per shift to offer callers product and service information and generate quotes.
- Built positive relationships with customers by providing exceptional customer service.
- Facilitated communication between customers and other departments to facilitate resolution.
- Developed in-depth understanding of product features and services to offer comprehensive support.
- Recorded customer interactions, inquiries and comments in customer service database for traceability.
- Utilized active listening skills to identify customer needs and provide appropriate solutions.
- Responded to customer inquiries via telephone and email.
- Prioritized customer service requests in order of urgency to promptly resolve critical issues.
- Demonstrated strong problem-solving skills by resolving customer issues during first call.
- Followed standard operating procedures when handling customer problems and complaints.
- Utilized basic troubleshooting techniques to diagnose and resolve customer inquiries.
- Provided timely feedback to management regarding customer inquiries and issues.
- Learned and maintained in-depth understanding of product and service information to offer knowledgeable and educated responses to diverse customer questions.
- Adhered to company policies and scripts to consistently achieve call-time and quality standards.
Admin Clerk
Iso Leso Optics
01.2015 - 11.2015
- Ensured confidentiality of sensitive documents through proper storage methods and restricted access control implementation.
- Reduced errors in data entry by carefully inputting information into computer systems with attention to detail.
- Improved customer satisfaction by promptly answering email inquiries and providing accurate information.
- Input data into spreadsheets and databases.
- Processed incoming and outgoing mail.
- Processed mail accurately and efficiently, ensuring that all correspondence was distributed to the correct recipients in a timely manner.
- Enhanced office organization with regular maintenance of files and claim records
- Provided quality clerical support through data entry, document management and email correspondence.
- Edited and proofread documents for accuracy and completeness.
Education
High School Diploma -
Westbury Secondary School
Westbury, Johannesburg, South Africa 01.2014 - 11.2014
Skills
Reliability
Attention to Detail
Multitasking Abilities
Reliability
Flexible and Adaptable
Organization
Calm Under Pressure
Microsoft Office
Analytical and Critical Thinking
Excellent Communication
Timeline
Administrative Team Leader
Iso Leso Optics
04.2023 - Current
Claims Assessor
Iso Leso Optics
12.2020 - 04.2023
Call Centre Agent
Iso Leso Optics
01.2017 - 11.2020
Admin Clerk
Iso Leso Optics
01.2015 - 11.2015
High School Diploma -
Westbury Secondary School
01.2014 - 11.2014