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
undefinedTimeline
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
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